Provider Demographics
NPI:1629257043
Name:HILL, FONTAINE S JR
Entity Type:Individual
Prefix:DR
First Name:FONTAINE
Middle Name:S
Last Name:HILL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 COLONEL WINSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8936
Mailing Address - Country:US
Mailing Address - Phone:615-776-5256
Mailing Address - Fax:615-776-7208
Practice Address - Street 1:16 COLONEL WINSTEAD DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8936
Practice Address - Country:US
Practice Address - Phone:615-776-5256
Practice Address - Fax:615-776-7208
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44488208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)