Provider Demographics
NPI:1992721849
Name:HILL, DAVID GARRETT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:GARRETT
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:257-655-7272
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:5131 ODONOVAN DR
Practice Address - Street 2:STE. 301
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4791
Practice Address - Country:US
Practice Address - Phone:225-765-5500
Practice Address - Fax:225-490-0396
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015686208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1317837Medicaid
LAI21727Medicare UPIN
LA1317837Medicaid