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General NPI Number Information
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NPI Number | 1497011696
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Entity Type | Individual
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Provider Name | DUSTIN NICOLAS HILL M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 611 ALCORN DR
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City | CORINTH
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State | MS
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Zip | 38834-9321
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Country | US
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Telephone | 225-335-0475
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Fax |
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Provider Business Mailing Address
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Address Line | 39 COUNTY ROAD 617
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City | CORINTH
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State | MS
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Zip | 38834-1130
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Country | US
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Telephone | 225-335-0475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 23692
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5859
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME137031
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 71705
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License Number State | GA
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