MEDICARE: DR. GREGORY A HILL 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
1	174400000X	Specialist	R7J50	MO
2	207W00000X	Ophthalmology Physician	R7J50	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700814225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY A HILL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 419161
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141
Country	:	US
Telephone Number	:	314-432-2580
Fax Number	:	314-432-0223

Provider Business Practice Location Address
First Line	:	12601 OLIVE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-6313
Country	:	US
Telephone Number	:	314-567-7771
Fax Number	:	314-567-7774

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	11/16/2021

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