Provider Demographics
NPI:1619945292
Name:HILL, KEITH REGEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:REGEN
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8 NEW MIDDLETON HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:GORDONSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38563-6603
Mailing Address - Country:US
Mailing Address - Phone:615-683-3400
Mailing Address - Fax:615-683-3402
Practice Address - Street 1:8 NEW MIDDLETON HWY
Practice Address - Street 2:SUITE A
Practice Address - City:GORDONSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38563-6603
Practice Address - Country:US
Practice Address - Phone:615-683-3400
Practice Address - Fax:615-683-3402
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37791207Q00000X
TNMD0000037791207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4277588OtherBCBST
TN4277588OtherBCBST
TN3887750Medicare PIN