Basic Information
Provider Information
NPI: 1316234131
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIGHLEY
FirstName: ADAM
MiddleName: DONALD
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7261 MERCY RD
Address2:  
City: OMAHA
State: NE
PostalCode: 681242311
CountryCode: US
TelephoneNumber: 4023986248
FaxNumber: 4028298513
Practice Location
Address1: 7710 MERCY RD STE 3000
Address2:  
City: OMAHA
State: NE
PostalCode: 681242350
CountryCode: US
TelephoneNumber: 4027179600
FaxNumber: 4027176014
Other Information
ProviderEnumerationDate: 06/30/2011
LastUpdateDate: 04/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200X7270NEN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001X28110NEY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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