Provider Demographics
NPI:1215566716
Name:HILL, KYLAN ROBERT
Entity type:Individual
Prefix:
First Name:KYLAN
Middle Name:ROBERT
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E. MARKET ST., MED II
Mailing Address - Street 2:DEPARTMENT OF OBSTETRICS & GYNECOLOGY
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309
Mailing Address - Country:US
Mailing Address - Phone:330-375-6119
Mailing Address - Fax:
Practice Address - Street 1:525 E. MARKET ST., MED II
Practice Address - Street 2:DEPARTMENT OF OBSTETRICS & GYNECOLOGY
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44309
Practice Address - Country:US
Practice Address - Phone:330-375-6119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program