Provider Demographics
NPI:1689867897
Name:HILTZ, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:HILTZ
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:P.O. BOX 3129
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3129
Mailing Address - Country:US
Mailing Address - Phone:706-737-4575
Mailing Address - Fax:706-731-5289
Practice Address - Street 1:630 13TH STREET
Practice Address - Street 2:SUITE 250
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-1017
Practice Address - Country:US
Practice Address - Phone:706-724-2500
Practice Address - Fax:706-823-5928
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA652612086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGA1172Medicaid
GA003106503A-B-C-DMedicaid
GA65261OtherMEDICAL LICENSE
KY3321861Medicare PIN
GA003106503A-B-C-DMedicaid