Provider Demographics
NPI:1780646992
Name:HILL, JOHN KIMBROUGH (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KIMBROUGH
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:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:828-694-8350
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:805 6TH AVE W STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4137
Practice Address - Country:US
Practice Address - Phone:828-692-8045
Practice Address - Fax:828-692-6630
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201474207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP01053582OtherRR MEDICARE
NC89133WGMedicaid
NC8901276Medicaid
NC2012221BOtherMEDICARE PTAN
NC89133WGMedicaid