Provider Demographics
NPI:1457322018
Name:HILL, BRITT BENTLEY (PAC)
Entity Type:Individual
Prefix:
First Name:BRITT
Middle Name:BENTLEY
Last Name:HILL
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 ROCK MERRITT AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-5658
Mailing Address - Country:US
Mailing Address - Phone:910-907-7144
Mailing Address - Fax:
Practice Address - Street 1:2817 ROCK MERRITT AVE
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-5252
Practice Address - Country:US
Practice Address - Phone:910-907-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03326363A00000X, 363A00000X
NVPA721363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2402660Medicaid
NV100500106Medicaid
NV970027580OtherRAILROAD MEDICARE
P36669Medicare UPIN
NV2402660Medicaid