Provider Demographics
NPI:1518080803
Name:HILL, CASSIE BROOK (MD)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:BROOK
Last Name:HILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:SUZANNE
Other - Last Name:BROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1041 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6309
Mailing Address - Country:US
Mailing Address - Phone:662-844-8754
Mailing Address - Fax:
Practice Address - Street 1:1041 S MADISON ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6309
Practice Address - Country:US
Practice Address - Phone:662-844-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19729207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01253270Medicaid