Provider Demographics
NPI:1558341651
Name:HILL, RAYMOND JOHN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JOHN
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7857
Mailing Address - Country:US
Mailing Address - Phone:719-548-8118
Mailing Address - Fax:719-495-4689
Practice Address - Street 1:1843 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7857
Practice Address - Country:US
Practice Address - Phone:719-548-8118
Practice Address - Fax:719-495-4689
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO#989170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07025471Medicaid
CO07025471Medicaid