Healthcare Provider Details

I. General information

NPI: 1679616957
Provider Name (Legal Business Name): REGAN R HILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463820 STATE ROAD 200 STE 103
YULEE FL
32097-3604
US

IV. Provider business mailing address

PO BOX 748667
ATLANTA GA
30374-8667
US

V. Phone/Fax

Practice location:
  • Phone: 904-321-3670
  • Fax: 904-376-3416
Mailing address:
  • Phone: 904-202-1032
  • Fax: 904-376-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberM-12561
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME159351
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: