Healthcare Provider Details

I. General information

NPI: 1093551749
Provider Name (Legal Business Name): HILL MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 DEER RUN LN
ORANGE CT
06477-2215
US

IV. Provider business mailing address

779 DEER RUN LN
ORANGE CT
06477-2215
US

V. Phone/Fax

Practice location:
  • Phone: 267-474-4040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GORDON SPENCER HILL
Title or Position: OWNER
Credential:
Phone: 475-223-0516