Provider Demographics
NPI:1376567644
Name:HILL MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:HILL MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WISSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-275-7770
Mailing Address - Street 1:170 MCGEHEE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-5012
Mailing Address - Country:US
Mailing Address - Phone:225-275-7770
Mailing Address - Fax:225-272-8899
Practice Address - Street 1:170 MCGEHEE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815
Practice Address - Country:US
Practice Address - Phone:225-275-7770
Practice Address - Fax:225-272-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA041202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1121142Medicaid
LA1121142Medicaid
LA5B248Medicare ID - Type Unspecified