Provider Demographics
NPI:1316563380
Name:HILL, GORDON SPENCER (MD)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:SPENCER
Last Name:HILL
Suffix:
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 1:779 DEER RUN LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2215
Mailing Address - Country:US
Mailing Address - Phone:475-223-0516
Mailing Address - Fax:
Practice Address - Street 1:779 DEER RUN LN
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2215
Practice Address - Country:US
Practice Address - Phone:475-223-0516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT220758207R00000X
CT73619207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine