Provider Demographics
NPI:1811020746
Name:HILL CENTER FOR DERMATOLOGY, PC
Entity Type:Organization
Organization Name:HILL CENTER FOR DERMATOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-526-1117
Mailing Address - Street 1:17560 S GOLDEN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6005
Mailing Address - Country:US
Mailing Address - Phone:303-526-1117
Mailing Address - Fax:303-278-0611
Practice Address - Street 1:17560 S GOLDEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6005
Practice Address - Country:US
Practice Address - Phone:303-526-1117
Practice Address - Fax:303-278-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801170Medicare ID - Type Unspecified
COG47305Medicare UPIN
COC801169Medicare PIN