Healthcare Provider Details

I. General information

NPI: 1427229699
Provider Name (Legal Business Name): BILLY WAYNE HILL, O.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205A WEST OKMULGEE
CHECOTAH OK
74426-2408
US

IV. Provider business mailing address

205A WEST OKMULGEE
CHECOTAH OK
74426-2408
US

V. Phone/Fax

Practice location:
  • Phone: 918-473-2308
  • Fax: 918-473-2961
Mailing address:
  • Phone: 918-473-2308
  • Fax: 918-473-2961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOK1083
License Number StateOK

VIII. Authorized Official

Name: DR. BILLY WAYNE HILL
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 918-473-2308