Provider Demographics
NPI:1093749194
Name:HILL, STEPHEN RICHARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RICHARD
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 RAMSEY ST # 116
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-3856
Mailing Address - Country:US
Mailing Address - Phone:910-488-2120
Mailing Address - Fax:910-822-7089
Practice Address - Street 1:6516 BURNSIDE PL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-2907
Practice Address - Country:US
Practice Address - Phone:910-257-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3076103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist