Basic Information
| Provider Information | |||||||||
| NPI: | 1598891665 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIGHLAND MEDICAL ASSOCIATES, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 COOLRIDGE STREET | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287922767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286943939 | ||||||||
| FaxNumber: | 8286920533 | ||||||||
| Practice Location | |||||||||
| Address1: | 165 COOLRIDGE STREET | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287922767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286943939 | ||||||||
| FaxNumber: | 8286920533 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2007 | ||||||||
| LastUpdateDate: | 12/01/2009 | ||||||||
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| AuthorizedOfficialLastName: | MESA | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | ROBERT | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER/OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8286943939 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PA-C | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | N | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | 363AM0700X | 103090 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.