Provider Demographics
NPI:1518046705
Name:J HILLMAN INC
Entity Type:Organization
Organization Name:J HILLMAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:HILLMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:662-327-7789
Mailing Address - Street 1:PO BOX 8938
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-0036
Mailing Address - Country:US
Mailing Address - Phone:662-327-7789
Mailing Address - Fax:662-327-7747
Practice Address - Street 1:428 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1937
Practice Address - Country:US
Practice Address - Phone:662-327-7789
Practice Address - Fax:662-327-7747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS06420261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00155361Medicaid
MS00155361Medicaid
MSC02983Medicare ID - Type UnspecifiedMEDICARE GROUP