Healthcare Provider Details

I. General information

NPI: 1366116618
Provider Name (Legal Business Name): MR. MICHAEL EUGENE HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 2ND ST STE 425
DAYTON OH
45402-1623
US

IV. Provider business mailing address

PO BOX 55
WALTON KY
41094-0055
US

V. Phone/Fax

Practice location:
  • Phone: 937-791-8541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: