Healthcare Provider Details

I. General information

NPI: 1396781563
Provider Name (Legal Business Name): JULIA JEANNE HILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 E BANNOCK ST PALLIATIVE MEDICINE
BOISE ID
83712-6241
US

IV. Provider business mailing address

190 E BANNOCK ST PALLIATIVE MEDICINE
BOISE ID
83712-6241
US

V. Phone/Fax

Practice location:
  • Phone: 208-381-2222
  • Fax: 208-381-5141
Mailing address:
  • Phone: 208-381-1624
  • Fax: 208-381-5141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM-6292
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberM6292
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM6292
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: