Provider Demographics
NPI:1013903160
Name:HILL, GREGORY GRIFFIN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:GRIFFIN
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 1:2619 DECATUR HWY
Mailing Address - Street 2:
Mailing Address - City:FULTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35068-1723
Mailing Address - Country:US
Mailing Address - Phone:205-841-9898
Mailing Address - Fax:205-841-9880
Practice Address - Street 1:2619 DECATUR HWY
Practice Address - Street 2:
Practice Address - City:FULTONDALE
Practice Address - State:AL
Practice Address - Zip Code:35068-1723
Practice Address - Country:US
Practice Address - Phone:205-841-9898
Practice Address - Fax:205-841-9880
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051503807Medicaid
AL051503807Medicaid
ALC73474Medicare UPIN
ALI635Medicare PIN