Healthcare Provider Details

I. General information

NPI: 1740283910
Provider Name (Legal Business Name): PAUL BRYAN HILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVE STE 200
MEMPHIS TN
38103
US

IV. Provider business mailing address

1407 UNION AVE STE 700
MEMPHIS TN
38104-3641
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-1679
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD19756
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: