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NPI Code Detail

MEDICARE: DR. SCOTT J HILLMANN M.D.

MEDICARE: DR. SCOTT J HILLMANN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician12852AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4020040211OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22572623OTHERAZAETNA
3AZ0830700OTHERAZBLUE CROSS BLUE SHIELD
52Z0573OTHERAZHEALTHNET

General Provider Information

NPI Number : 1023014016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT J HILLMANN M.D.
Provider Business Mailing Address
First Line : 16601 N 40TH ST STE 204
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-3356
Country : US
Telephone Number : 602-996-4747
Fax Number : 602-953-5466
Provider Business Practice Location Address
First Line : 16601 N 40TH ST STE 204
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-3356
Country : US
Telephone Number : 602-996-4747
Fax Number : 602-953-5466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 07/21/2022

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