Provider Demographics
NPI:1063161909
Name:HILTON, PHILLIP NICHOLAS (DO)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:NICHOLAS
Last Name:HILTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 E VALLEY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6651
Mailing Address - Country:US
Mailing Address - Phone:801-349-6489
Mailing Address - Fax:
Practice Address - Street 1:717 S HOUSTON AVE # A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9023
Practice Address - Country:US
Practice Address - Phone:918-382-3178
Practice Address - Fax:918-382-6789
Is Sole Proprietor?:No
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program