Provider Demographics
NPI:1588696421
Name:HILL, GEORGE AUSTIN (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:AUSTIN
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:200 3RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8626
Practice Address - Country:US
Practice Address - Phone:941-792-0340
Practice Address - Fax:941-567-3171
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064264208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012602100Medicaid
FL222896OtherUNIVERSAL
FLP01040804OtherRAILROAD MCR
FLP102257OtherFREEDOM HEALTHCARE
FL1193135OtherWELLCARE
FL4376189OtherAETNA
FL23042OtherBCBS FL
FL353767OtherAVMED
FLP01811146OtherCLEAR HEALTH
FLP513325OtherOPTIMUM
FLP01040804OtherRAILROAD MCR
FL23042ZMedicare PIN
FL23042XMedicare PIN