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General NPI Number Information
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NPI Number | 1700286341
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Entity Type | Organization
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Legal Business Name | HILL DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 309 SE FRANK PHILLIPS BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74003-3643
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Country | US
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Telephone | 918-214-8888
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Fax | 918-214-8887
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Provider Business Mailing Address
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Address Line | 309 SE FRANK PHILLIPS BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74003-3643
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Country | US
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Telephone | 918-214-8888
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Fax | 918-214-8887
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA L HILL
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Credential | M.D.
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Telephone | 918-214-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1214
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 17349
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License Number State | OK
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