Provider Demographics
NPI:1851316970
Name:HILL, HARRY HAYDON (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:HAYDON
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 1:8391 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6048
Mailing Address - Country:US
Mailing Address - Phone:775-982-4590
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:5470 KIETZKE LN STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2099
Practice Address - Country:US
Practice Address - Phone:775-800-3645
Practice Address - Fax:775-284-8898
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036159244208100000X
FLME125878208100000X
NV04383208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1851316970Medicaid
NVC96147Medicare UPIN
NV1851316970Medicaid