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General NPI Number Information
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NPI Number | 1699086108
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Entity Type | Individual
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Provider Name | STACEY L HILL PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 1000 JOHNSON FERRY RD NE NORTHSIDE HOSPITAL
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City | ATLANTA
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State | GA
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Zip | 30342-1606
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Country | US
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Telephone | 404-303-3760
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Fax | 404-303-3759
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Provider Business Mailing Address
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Address Line | 9390 HIGHWAY 166
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City | WINSTON
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State | GA
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Zip | 30187-1261
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Country | US
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Telephone | 678-715-5670
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Fax | 404-303-3759
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2123
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License Number State | GA
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