Provider Demographics
NPI:1508952631
Name:HILL, JIMMY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:SCOTT
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIMMY
Other - Middle Name:SCOTT
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5025 LAKE RUN DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM,
Mailing Address - State:AL
Mailing Address - Zip Code:35242
Mailing Address - Country:US
Mailing Address - Phone:205-969-0400
Mailing Address - Fax:
Practice Address - Street 1:PEDIATRIC ENT ASSOCIATES
Practice Address - Street 2:1940 ELMER J. BISSELL ROAD
Practice Address - City:BIRMINGHAM,
Practice Address - State:AL
Practice Address - Zip Code:35243
Practice Address - Country:US
Practice Address - Phone:205-638-4949
Practice Address - Fax:205-638-4983
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21600207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7153007OtherCIGNAHEALTHCARE
AL51051712Medicaid
AL25457OtherSOUTHERN HEALTH SERVICES
AL35677OtherHEALTH SPRING
AL51051712OtherBCBS CHILDRENS SOUTH
AL000045532Medicaid
AL1010154OtherUHC
AL51045532OtherBLUECROSSBS CHILDRENS HOS
ALF43053Medicare UPIN
AL25457OtherSOUTHERN HEALTH SERVICES