Provider Demographics
NPI:1194783811
Name:HILLSGROVE, DONNA E (OD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:E
Last Name:HILLSGROVE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 SIX FORKS RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6156
Mailing Address - Country:US
Mailing Address - Phone:919-847-0187
Mailing Address - Fax:919-676-2231
Practice Address - Street 1:1201 RALEIGH RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4047
Practice Address - Country:US
Practice Address - Phone:919-942-3320
Practice Address - Fax:919-942-7268
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1279152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89093E8Medicaid
NC093E8OtherBLUE CROSS BLUE SHIELD
NCP00791295OtherRAILROAD MEDICARE
NC246641CMedicare PIN