=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366537623
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIE JAMES HILL D.D.S.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 514 EAST WOODROW WILSON AVE SUITE F
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39216-4505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-982-3132
-----------------------------------------------------
Fax | 601-982-3136
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 514 F EAST WOODROW WILSON AVE
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39216-4505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-982-3121
-----------------------------------------------------
Fax | 601-982-3136
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 1837-79
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | OS-24-79
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------