Basic Information
Provider Information
NPI: 1558316232
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: MICHAEL
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3810
Address2:  
City: JOPLIN
State: MO
PostalCode: 64803
CountryCode: US
TelephoneNumber: 4173471078
FaxNumber: 4173471078
Practice Location
Address1: 1102 WEST 32ND STREET
Address2:  
City: JOPLIN
State: MO
PostalCode: 64804
CountryCode: US
TelephoneNumber: 4173471078
FaxNumber: 4173471079
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 10/18/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X109928MOY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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