Provider Demographics
NPI:1023258076
Name:EDWARD P. HILL, IV, MD
Entity type:Organization
Organization Name:EDWARD P. HILL, IV, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:POLK
Authorized Official - Last Name:HILL
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:256-234-3004
Mailing Address - Street 1:3368 HIGHWAY 280
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3393
Mailing Address - Country:US
Mailing Address - Phone:256-234-3007
Mailing Address - Fax:256-234-0313
Practice Address - Street 1:3368 HIGHWAY 280
Practice Address - Street 2:SUITE 120
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3393
Practice Address - Country:US
Practice Address - Phone:256-234-3007
Practice Address - Fax:256-234-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000035615Medicaid
AL1144237371OtherNPI
ALG03482Medicare UPIN