Provider Demographics
NPI:1639255128
Name:PALMER HILL, ELIZABETH GAYLE (DMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GAYLE
Last Name:PALMER HILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 106
Mailing Address - Street 2:2370 HILLCREST RD SUITE G
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3838
Mailing Address - Country:US
Mailing Address - Phone:251-414-5142
Mailing Address - Fax:251-634-0033
Practice Address - Street 1:6154 OMNI PARK DRIVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609
Practice Address - Country:US
Practice Address - Phone:251-414-5142
Practice Address - Fax:251-634-0033
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5195122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
39954Medicare UPIN