Provider Demographics
NPI:1487647905
Name:HILLS, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:HILLS
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 1:842 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7134
Mailing Address - Country:US
Mailing Address - Phone:541-773-2493
Mailing Address - Fax:541-779-3027
Practice Address - Street 1:842 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7134
Practice Address - Country:US
Practice Address - Phone:541-773-2493
Practice Address - Fax:541-779-3027
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060220L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016923040017Medicaid
PA300087069OtherRAILROAD MEDICARE
PA0016923040001Medicaid
PA0016923040002Medicaid
PA0016923040014Medicaid
PA0016923040016Medicaid
PA0016923040016Medicaid
PA0016923040002Medicaid
PA008595PQLMedicare PIN
PA008595EF4Medicare PIN
PA008595FJDMedicare PIN
PA008595H96Medicare PIN