Provider Demographics
NPI:1003006321
Name:HILL, SCOTT STEWART (MSPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:STEWART
Last Name:HILL
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:5850 EUBANK BLVD NE # B49-242
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-6132
Mailing Address - Country:US
Mailing Address - Phone:505-350-0808
Mailing Address - Fax:
Practice Address - Street 1:5850 EUBANK BLVD NE # B49-242
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-6132
Practice Address - Country:US
Practice Address - Phone:505-350-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1638171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor