Provider Demographics
NPI:1154485050
Name:HILL, TED W (MD)
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:W
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 NORTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-4424
Mailing Address - Country:US
Mailing Address - Phone:615-452-1192
Mailing Address - Fax:
Practice Address - Street 1:556 HARTSVILLE PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2450
Practice Address - Country:US
Practice Address - Phone:615-451-0038
Practice Address - Fax:615-451-0121
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD10002207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBO3351Medicare UPIN