Provider Demographics
NPI:1497105258
Name:HILL, JAMES (NP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1218
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180-5218
Mailing Address - Country:US
Mailing Address - Phone:803-635-6461
Mailing Address - Fax:803-635-4200
Practice Address - Street 1:880 W MOULTRIE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-2411
Practice Address - Country:US
Practice Address - Phone:803-635-6461
Practice Address - Fax:803-635-4200
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily