Provider Demographics
NPI:1346422979
Name:DR KENT B HILL OPTOMETRIST PC
Entity Type:Organization
Organization Name:DR KENT B HILL OPTOMETRIST PC
Other - Org Name:UNION EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:B
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:636-583-3322
Mailing Address - Street 1:507 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-2121
Mailing Address - Country:US
Mailing Address - Phone:636-583-3322
Mailing Address - Fax:636-583-8328
Practice Address - Street 1:507 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-2121
Practice Address - Country:US
Practice Address - Phone:636-583-3322
Practice Address - Fax:636-583-8328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO2166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO410031364OtherRAILROAD MEDICARE
MO0434960001Medicare NSC