Provider Demographics
NPI:1447411319
Name:HILL, VINCENT ELLIS (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:ELLIS
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 FLORENCE AVE # 115
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2605
Mailing Address - Country:US
Mailing Address - Phone:202-488-0948
Mailing Address - Fax:
Practice Address - Street 1:309 FLORENCE AVE # 115
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2605
Practice Address - Country:US
Practice Address - Phone:202-488-0948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD11112208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice