Provider Demographics
NPI:1669471306
Name:HILL, ROBERT L (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:HILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:OH
Mailing Address - Zip Code:43506-1545
Mailing Address - Country:US
Mailing Address - Phone:419-636-1531
Mailing Address - Fax:419-636-1025
Practice Address - Street 1:1313 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1545
Practice Address - Country:US
Practice Address - Phone:419-636-1531
Practice Address - Fax:419-636-1025
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4358/T264152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0886251Medicaid
OH0886251Medicaid
OH1063534329Medicare NSC
OH1320640001Medicare NSC
OH410046115Medicare PIN
OHU34659Medicare UPIN