Healthcare Provider Details

I. General information

NPI: 1770865677
Provider Name (Legal Business Name): JUSTIN E HILL PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5653 FRIST BLVD
HERMITAGE TN
37076-2062
US

IV. Provider business mailing address

345 23RD AVE N SUITE 301
NASHVILLE TN
37203-1513
US

V. Phone/Fax

Practice location:
  • Phone: 615-232-8812
  • Fax:
Mailing address:
  • Phone: 615-329-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2032
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: