Provider Demographics
NPI:1396072070
Name:HILL, BLAKE MARTIN (PA-C)
Entity type:Individual
Prefix:MR
First Name:BLAKE
Middle Name:MARTIN
Last Name:HILL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1600 SPECHT POINT RD
Mailing Address - Street 2:STE 127
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4311
Mailing Address - Country:US
Mailing Address - Phone:970-493-7733
Mailing Address - Fax:970-493-8745
Practice Address - Street 1:1600 SPECHT POINT RD
Practice Address - Street 2:SUITE 127
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4311
Practice Address - Country:US
Practice Address - Phone:970-493-7733
Practice Address - Fax:970-493-8745
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2016-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COPAL-2927363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant