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Contact Information

HIGHLAND CLINIC, A PROF MED CORP
1400 E BERT KOUN LOOP
#103
SHREVEPORT, LA71105-5603
 Phone: 318-222-8402
 Fax: 318-222-4556
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for HIGHLAND CLINIC, A PROF MED CORP

NPI # 1891168761
LBN Legal business name HIGHLAND CLINIC, A PROF MED CORP
Authorized official DEBBIE SMITH - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 11/02/2015
Last updated 12/08/2015 - About 10 years ago
Identifiers
LA Medicaid 1038300
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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