Provider Demographics
NPI:1518942309
Name:HILL, STANLEY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:PAUL
Last Name:HILL
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 1:17560 S GOLDEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2694
Mailing Address - Country:US
Mailing Address - Phone:303-526-1117
Mailing Address - Fax:303-278-0611
Practice Address - Street 1:17560 S GOLDEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2694
Practice Address - Country:US
Practice Address - Phone:303-526-1117
Practice Address - Fax:303-278-0611
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG47305Medicare UPIN
COC801169Medicare ID - Type Unspecified