Healthcare Provider Details

I. General information

NPI: 1851363410
Provider Name (Legal Business Name): JAMES HOWARD HILLIS II RPT/ ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W BROOKS ST RM E8
NORMAN OK
73019-1018
US

IV. Provider business mailing address

3005 TIMOTHY WAY
EDMOND OK
73034-7006
US

V. Phone/Fax

Practice location:
  • Phone: 405-325-8206
  • Fax: 405-325-8388
Mailing address:
  • Phone: 405-330-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT1273
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT29
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: