Provider Demographics
NPI:1235235656
Name:HILL, ANDREW JAMES (OD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:HILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66053-0397
Mailing Address - Country:US
Mailing Address - Phone:913-837-3636
Mailing Address - Fax:913-837-5641
Practice Address - Street 1:3 S BERKLEY ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:KS
Practice Address - Zip Code:66053-3578
Practice Address - Country:US
Practice Address - Phone:913-837-3636
Practice Address - Fax:913-837-5641
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1481-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS22-00242OtherUNITED HEALTH CARE
KS2267039OtherAETNA
KS052535OtherBCBS OF KANSAS
KS12166OtherPRINCIPAL HEALTH CARE
KS24385010OtherBCBS OF KANSAS CITY
KS2267039OtherAETNA
KS052535HIMedicare ID - Type Unspecified