Provider Demographics
NPI:1487746624
Name:HIGH, LARRY A JR (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:A
Last Name:HIGH
Suffix:JR
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 1:132 FOY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2417
Mailing Address - Country:US
Mailing Address - Phone:252-443-6622
Mailing Address - Fax:252-443-6404
Practice Address - Street 1:132 FOY DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2417
Practice Address - Country:US
Practice Address - Phone:252-443-6622
Practice Address - Fax:252-443-6404
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17992207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC42251OtherBLUE CROSS BLUE SHIELD
NC160030998OtherMEDICARE RAILROAD
NC8942251Medicaid
NC207263Medicare PIN
NC42251OtherBLUE CROSS BLUE SHIELD