Healthcare Provider Details

I. General information

NPI: 1689776320
Provider Name (Legal Business Name): BILL E HUKILL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8477 DAVISON RD
DAVISON MI
48423-2114
US

IV. Provider business mailing address

8477 DAVISON RD
DAVISON MI
48423-2114
US

V. Phone/Fax

Practice location:
  • Phone: 810-653-5933
  • Fax: 810-653-5927
Mailing address:
  • Phone: 810-653-5933
  • Fax: 810-653-5927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101012833
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: