Basic Information
Provider Information
NPI: 1942280292
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: JAMES
MiddleName: WAYNE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 658
Address2:  
City: GAINESVILLE
State: GA
PostalCode: 305030658
CountryCode: US
TelephoneNumber: 7707181122
FaxNumber: 7705357445
Practice Location
Address1: 725 JESSE JEWELL PKWY SE
Address2: SUITE 200
City: GAINESVILLE
State: GA
PostalCode: 305013834
CountryCode: US
TelephoneNumber: 7702972200
FaxNumber: 7705348139
Other Information
ProviderEnumerationDate: 01/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X022418GAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
938384001GACIGNAOTHER
1004521001GAAMERIGROUPOTHER
070033101GAUNITED HEALTHCAREOTHER
5219728401GABCBSOTHER
33879201GAWELLCAREOTHER


Home