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General NPI Number Information
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NPI Number | 1235469917
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Entity Type | Organization
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Legal Business Name | MICHAEL J. HILL O.D. PA
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Dates
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Enumeration Date | 01/02/2010
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Last Update Date | 01/02/2010
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Provider Practice Location Address
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Address Line | 300 MARY ESTHER BLVD
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City | MARY ESTHER
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State | FL
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Zip | 32569-1693
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Country | US
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Telephone | 850-362-0127
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Fax | 850-664-6254
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Provider Business Mailing Address
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Address Line | 702 STANDISH LN
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-3237
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Country | US
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Telephone | 850-543-2171
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL JOEL HILL
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Credential | O.D.
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Telephone | 850-543-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4326
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License Number State | FL
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