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Individual

STEPHEN HIGHTOWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4005 HIGH RESORT BLVD SE, RIO RANCHO, NM 87124-5906
(505) 462-6000
(505) 462-8476
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
8545
NM
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
85-45
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35287
NM
Enumeration date
10/03/2006
Last updated
04/13/2016
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