Provider Demographics
NPI:1013179936
Name:HILL, LISA J (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:HILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6556 S BIG COTTONWOOD CANYON RD STE 500A
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3596
Mailing Address - Country:US
Mailing Address - Phone:385-246-1117
Mailing Address - Fax:385-246-1117
Practice Address - Street 1:6556 S BIG COTTONWOOD CANYON RD STE 500A
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3596
Practice Address - Country:US
Practice Address - Phone:385-246-1117
Practice Address - Fax:385-246-1117
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT375387-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine