Provider Demographics
NPI:1972529402
Name:HILLMAN, BILLY WRAY JR (MD)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:WRAY
Last Name:HILLMAN
Suffix:JR
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 1:426 HIGHWAY 308
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5752
Mailing Address - Country:US
Mailing Address - Phone:985-447-2628
Mailing Address - Fax:985-447-2048
Practice Address - Street 1:426 HIGHWAY 308
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5752
Practice Address - Country:US
Practice Address - Phone:985-447-2628
Practice Address - Fax:985-447-2048
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538330337OtherMEDICARE NPI
LA1347507Medicaid
1972529402OtherINDIVIDUAL NPI
LA51821F600Medicare ID - Type Unspecified
1538330337OtherMEDICARE NPI