Healthcare Provider Details

I. General information

NPI: 1477058428
Provider Name (Legal Business Name): MARY KATHERINE HILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11990 GRANT ST STE 300
NORTHGLENN CO
80233-1135
US

IV. Provider business mailing address

1056 S 88TH ST
LOUISVILLE CO
80027-9460
US

V. Phone/Fax

Practice location:
  • Phone: 303-442-6647
  • Fax: 303-442-2696
Mailing address:
  • Phone: 303-442-6647
  • Fax: 303-442-2696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberDR.0067924
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: