Provider Demographics
NPI:1245469402
Name:EDWIN E. HILL
Entity type:Organization
Organization Name:EDWIN E. HILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-579-4111
Mailing Address - Street 1:900 N PORTER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6425
Mailing Address - Country:US
Mailing Address - Phone:405-579-4111
Mailing Address - Fax:405-579-4223
Practice Address - Street 1:900 N PORTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6425
Practice Address - Country:US
Practice Address - Phone:405-579-4111
Practice Address - Fax:405-579-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18485323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100132050BMedicaid
OK242534701Medicare PIN
OK100132050BMedicaid