Provider Demographics
NPI:1063797827
Name:HIGHTOWER, GEORGE BARYON (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:BARYON
Last Name:HIGHTOWER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 89 BOX 8190
Mailing Address - Street 2:
Mailing Address - City:TALKEETNA
Mailing Address - State:AK
Mailing Address - Zip Code:99676-9701
Mailing Address - Country:US
Mailing Address - Phone:907-733-2273
Mailing Address - Fax:907-733-1735
Practice Address - Street 1:HC 89 34300 S TALKEETNA SPUR ROAD
Practice Address - Street 2:
Practice Address - City:TALKEETNA
Practice Address - State:AK
Practice Address - Zip Code:99676
Practice Address - Country:US
Practice Address - Phone:907-733-2273
Practice Address - Fax:907-733-1735
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48661208D00000X
ND12175208D00000X
AK140816208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF11539Medicare UPIN