MEDICARE: TONY R HILL DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	3579	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295723245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONY R HILL DO

Provider Business Mailing Address
First Line	:	DEPT. 672
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74182-0001
Country	:	US
Telephone Number	:	866-321-8433
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 S. ASPEN
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-8792
Country	:	US
Telephone Number	:	918-286-6331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	07/26/2010

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