Provider Demographics
NPI:1346410891
Name:E DARRYL HILL DPM
Entity Type:Organization
Organization Name:E DARRYL HILL DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:E
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-465-5151
Mailing Address - Street 1:2257 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701
Mailing Address - Country:US
Mailing Address - Phone:724-465-5151
Mailing Address - Fax:724-465-7919
Practice Address - Street 1:2257 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701
Practice Address - Country:US
Practice Address - Phone:724-465-5151
Practice Address - Fax:724-465-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002995L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001194230001Medicaid
PA0881860001Medicare NSC
PA510855Medicare PIN
T30729Medicare UPIN