Healthcare Provider Details

I. General information

NPI: 1750459913
Provider Name (Legal Business Name): NEIL STRAIT HILL NORTH VERNON FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 VETERANS DR SUITE A
NORTH VERNON IN
47265-2602
US

IV. Provider business mailing address

939 VETERANS DR SUITE A
NORTH VERNON IN
47265-2602
US

V. Phone/Fax

Practice location:
  • Phone: 812-352-8333
  • Fax: 812-352-8233
Mailing address:
  • Phone: 812-352-8333
  • Fax: 812-352-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001952A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71000295A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02001786A
License Number StateIN

VIII. Authorized Official

Name: NEIL STRAIT HILL
Title or Position: OWNER
Credential: DO
Phone: 812-352-8333