Provider Demographics
NPI:1740237171
Name:HILL, TERRANCE ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:ALLEN
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 1:55D TWIN OAKS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-2851
Mailing Address - Country:US
Mailing Address - Phone:541-451-6380
Mailing Address - Fax:541-451-6385
Practice Address - Street 1:55D TWIN OAKS AVE STE 2
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2851
Practice Address - Country:US
Practice Address - Phone:541-451-6380
Practice Address - Fax:541-451-6385
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13085207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR260992Medicaid
ORC91520Medicare UPIN
OR260992Medicaid