Provider Demographics
NPI:1588636955
Name:HILL, WILLIAM L (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 WALMART DR
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:MO
Mailing Address - Zip Code:63080-3326
Mailing Address - Country:US
Mailing Address - Phone:573-860-4455
Mailing Address - Fax:573-860-4456
Practice Address - Street 1:556 WALMART DR
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-3326
Practice Address - Country:US
Practice Address - Phone:573-860-4455
Practice Address - Fax:573-860-4456
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE006261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO113056OtherBLUE CROSS BLUE SHIELD
MO5910709OtherAETNA
MOCE006261OtherSTATE LICENSE
MO278584OtherHEALTHLINK
MOCE006261OtherSTATE LICENSE
MO5910709OtherAETNA