Provider Demographics
NPI:1619292109
Name:HILL, NATHAN C (PA)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:C
Last Name:HILL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-8809
Mailing Address - Country:US
Mailing Address - Phone:828-324-2800
Mailing Address - Fax:828-294-9141
Practice Address - Street 1:2165 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8809
Practice Address - Country:US
Practice Address - Phone:828-324-2800
Practice Address - Fax:828-294-9141
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003041363AS0400X
NC0010-06567363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0068951Medicaid
PA83901Medicare PIN