MEDICARE: JOSH UTAH HILL PA-C

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	363A00000X	Physician Assistant	50-00-1493	OH
2	363A00000X	Physician Assistant	PA562	KY

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	:	1427056167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSH UTAH HILL PA-C

Provider Business Mailing Address
First Line	:	191 WAL MART WAY
Second Line	:
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-7518
Country	:	US
Telephone Number	:	606-759-0021
Fax Number	:	606-759-0086

Provider Business Practice Location Address
First Line	:	1210 KY HIGHWAY 36 E
Second Line	:
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-7490
Country	:	US
Telephone Number	:	859-235-3562
Fax Number	:	859-234-3967

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	10/02/2015

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Directions to “ JOSH UTAH HILL PA-C” Practice Location

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