Healthcare Provider Details

I. General information

NPI: 1164767042
Provider Name (Legal Business Name): JAMES AVON HILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12028 N MAY AVE
OKLAHOMA CITY OK
73120-6807
US

IV. Provider business mailing address

12028 N MAY AVE
OKLAHOMA CITY OK
73120-6807
US

V. Phone/Fax

Practice location:
  • Phone: 405-751-8930
  • Fax: 405-751-8950
Mailing address:
  • Phone: 405-751-8930
  • Fax: 405-751-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number8106
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: