Healthcare Provider Details

I. General information

NPI: 1770526188
Provider Name (Legal Business Name): NATHAN EARL HILTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/25/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 IVY ST
BRAINERD MN
56401-3000
US

IV. Provider business mailing address

7401 METRO BLVD STE 210
EDINA MN
55439-3086
US

V. Phone/Fax

Practice location:
  • Phone: 218-828-7585
  • Fax: 218-828-7588
Mailing address:
  • Phone: 952-920-4915
  • Fax: 952-915-6091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number60228
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: