Provider Demographics
NPI:1730105081
Name:HILTON, FREDERICK KELKER JR (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:KELKER
Last Name:HILTON
Suffix:JR
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 1:3061 FIELDSTONE WAY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1718
Mailing Address - Country:US
Mailing Address - Phone:859-296-9900
Mailing Address - Fax:859-296-9603
Practice Address - Street 1:3061 FIELDSTONE WAY
Practice Address - Street 2:SUITE 700
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1718
Practice Address - Country:US
Practice Address - Phone:859-296-9900
Practice Address - Fax:859-296-9603
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY37903705OtherMEDICAID LAB GRP
GACB5773OtherRR MEDICARE GRP
KY4000501OtherMEDICARE LAB GRP
KY64022791Medicaid
KY0623726Medicare ID - Type Unspecified
H26523Medicare UPIN