Provider Demographics
NPI:1386601946
Name:HILL, PHIL H (PA)
Entity type:Individual
Prefix:
First Name:PHIL
Middle Name:H
Last Name:HILL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1134
Mailing Address - Country:US
Mailing Address - Phone:256-456-0226
Mailing Address - Fax:256-456-0231
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 205
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1134
Practice Address - Country:US
Practice Address - Phone:256-456-0226
Practice Address - Fax:256-456-0231
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPA 21363AS0400X
ALPA.21363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL168053Medicaid
AL193305Medicaid
ALS13150Medicare UPIN
AL193305Medicaid