Organization
HIGHLANDS HOSPITAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK G BLACKWELL (CFO)
(606) 886-7548
Entity
Organization
Contact information
Practice address
5000 KY ROUTE 321, PRESTONSBURG, KY 41653-9113
(606) 886-8511
(606) 886-7761
Mailing address
PO BOX 668, PRESTONSBURG, KY 41653-0668
(606) 886-8511
(606) 886-7761
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
100124
KY
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
100124
KY
282N00000X
General Acute Care Hospital
100124
KY
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054640
ANTHEM BLUE CROSS PROVIDE
KY
01
—
000000061959
ANTHEM BC REF LAB
KY
05
—
01007137
—
KY
05
—
0327882
—
OH
Enumeration date
10/02/2006
Last updated
06/13/2019
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