Provider Demographics
NPI:1003849951
Name:HILL, SCOT M (PA)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:M
Last Name:HILL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SISKIN PLZ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-1306
Mailing Address - Country:US
Mailing Address - Phone:423-803-2226
Mailing Address - Fax:423-803-2222
Practice Address - Street 1:1 SISKIN PLZ STE 101
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1306
Practice Address - Country:US
Practice Address - Phone:423-803-2226
Practice Address - Fax:423-803-2222
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000273363A00000X, 363AM0700X
GA004865363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4219127OtherBCBSTN
TN4219127OtherBCBST
TN1512855Medicaid
TN4219127OtherBCBSTN
TN3667454Medicaid
S43755Medicare UPIN
TN36674541Medicare PIN
TN4219127OtherBCBSTN