Provider Demographics
NPI:1194856062
Name:HILL, GERALD L (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:L
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 1:3802 21ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1011
Mailing Address - Country:US
Mailing Address - Phone:806-791-1272
Mailing Address - Fax:806-791-1955
Practice Address - Street 1:3802 21ST ST STE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1011
Practice Address - Country:US
Practice Address - Phone:806-791-1272
Practice Address - Fax:806-791-1955
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD32632083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C16912Medicare UPIN