Organization
HIGH PLAINS MEDICAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDI R MILHON (BILLER)
(620) 624-5691
Entity
Organization
Contact information
Practice address
623 AVENUE C, BEAVER, OK 73932
(580) 625-4854
(580) 625-4854
Mailing address
2 PLAZA DR, LIBERAL, KS 67901-2743
(620) 624-5691
(620) 624-3656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100723540A
—
OK
01
—
110482
BCBS OF KANSAS
KS
Enumeration date
04/07/2006
Last updated
03/11/2009
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