Provider Demographics
NPI:1427229699
Name:BILLY WAYNE HILL, O.D., P.C.
Entity type:Organization
Organization Name:BILLY WAYNE HILL, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:918-473-2308
Mailing Address - Street 1:205A WEST OKMULGEE
Mailing Address - Street 2:
Mailing Address - City:CHECOTAH
Mailing Address - State:OK
Mailing Address - Zip Code:74426-2408
Mailing Address - Country:US
Mailing Address - Phone:918-473-2308
Mailing Address - Fax:918-473-2961
Practice Address - Street 1:205A WEST OKMULGEE
Practice Address - Street 2:
Practice Address - City:CHECOTAH
Practice Address - State:OK
Practice Address - Zip Code:74426-2408
Practice Address - Country:US
Practice Address - Phone:918-473-2308
Practice Address - Fax:918-473-2961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK1083152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK410002358OtherRAILROAD MEDICARE
OK731227583001OtherBLUE CROSS BLUE SHIELD
OK100762010AMedicaid
OKA002OtherCHAMPVA
OK731227583001OtherBLUE CROSS BLUE SHIELD
OK410002358OtherRAILROAD MEDICARE
OKA002OtherCHAMPVA
OK441565567Medicare PIN