Provider Demographics
NPI:1851363410
Name:HILLIS, JAMES HOWARD II (RPT/ ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HOWARD
Last Name:HILLIS
Suffix:II
Gender:M
Credentials:RPT/ ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 TIMOTHY WAY
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7006
Mailing Address - Country:US
Mailing Address - Phone:405-330-3005
Mailing Address - Fax:
Practice Address - Street 1:180 W BROOKS ST
Practice Address - Street 2:RM E8
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73019-1018
Practice Address - Country:US
Practice Address - Phone:405-325-8206
Practice Address - Fax:405-325-8388
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT12732251S0007X
OKAT292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer