Basic Information
| Provider Information | |||||||||
| NPI: | 1124635180 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIGHLAND CENTER FOR WOMEN'S HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 S 28TH AVE STE 326 | ||||||||
| Address2: | |||||||||
| City: | HATTIESBURG | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394017152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012881823 | ||||||||
| FaxNumber: | 6012884360 | ||||||||
| Practice Location | |||||||||
| Address1: | 128 HIGHLAND PKWY STE 202 | ||||||||
| Address2: | |||||||||
| City: | PICAYUNE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394665578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013589422 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2020 | ||||||||
| LastUpdateDate: | 09/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | LOWRIMORE | ||||||||
| AuthorizedOfficialFirstName: | COURTNEY | ||||||||
| AuthorizedOfficialMiddleName: | SHIELDS | ||||||||
| AuthorizedOfficialTitleorPosition: | CONTRACT ANALYST | ||||||||
| AuthorizedOfficialTelephone: | 6012881823 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FORREST COUNTY GENERAL HOSPITAL | ||||||||
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| NPICertificationDate: | 07/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.