Provider Demographics
NPI:1104870914
Name:HILL, JAMES EDWARD (PHD, RD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9512 PERALTA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6358
Mailing Address - Country:US
Mailing Address - Phone:505-823-1943
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108
Practice Address - Country:US
Practice Address - Phone:505-823-1943
Practice Address - Fax:505-262-5455
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered