Provider Demographics
NPI:1639175706
Name:HILL, ROGER R (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:R
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 1:301 LINVILLE ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-7206
Mailing Address - Country:US
Mailing Address - Phone:828-584-2481
Mailing Address - Fax:828-584-8371
Practice Address - Street 1:301 LINVILLE ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-7206
Practice Address - Country:US
Practice Address - Phone:828-584-2481
Practice Address - Fax:828-584-8371
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35369207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8942411Medicaid
NC1639175706Medicaid
NC8942411Medicaid
2175333EOtherMEDICARE INDIVIDUAL ID
NC2175333BMedicare ID - Type Unspecified