Healthcare Provider Details

I. General information

NPI: 1154710333
Provider Name (Legal Business Name): DEREK L HILL DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 E 10 MILE RD STE 400
FERNDALE MI
48220-3041
US

IV. Provider business mailing address

PO BOX 71587
MADISON HEIGHTS MI
48071-0587
US

V. Phone/Fax

Practice location:
  • Phone: 248-268-4296
  • Fax: 888-850-3877
Mailing address:
  • Phone: 586-751-3480
  • Fax: 888-850-3877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DEREK L HILL
Title or Position: PHYSICIAN
Credential: DO
Phone: 248-268-4296