Provider Demographics
NPI:1205224276
Name:HILL, SHAWN STEPHEN (MPAS)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:STEPHEN
Last Name:HILL
Suffix:
Gender:M
Credentials:MPAS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:555 W SR 164
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:UT
Practice Address - Zip Code:84653-1635
Practice Address - Country:US
Practice Address - Phone:801-465-4813
Practice Address - Fax:801-812-5433
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT9243515-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant