Healthcare Provider Details

I. General information

NPI: 1407818917
Provider Name (Legal Business Name): MICHAEL KEVIN HILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 STARBRUSH CIR
COVINGTON LA
70433-7208
US

IV. Provider business mailing address

1375 CORPORATE SQUARE DR
SLIDELL LA
70458-3147
US

V. Phone/Fax

Practice location:
  • Phone: 985-871-0095
  • Fax: 985-871-0529
Mailing address:
  • Phone: 985-726-2655
  • Fax: 985-643-9808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number016632
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: