Provider Demographics
NPI:1740277375
Name:HILMAN, MICHAEL GLENN (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GLENN
Last Name:HILMAN
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 1:12 MEDICAL LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4913
Mailing Address - Country:US
Mailing Address - Phone:501-329-3600
Mailing Address - Fax:501-329-2435
Practice Address - Street 1:12 MEDICAL LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4913
Practice Address - Country:US
Practice Address - Phone:501-329-3600
Practice Address - Fax:501-329-2435
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC7290OtherSTATE LICENSE NUMBER
AR114220001Medicaid
AR52069Medicare ID - Type Unspecified
ARC7290OtherSTATE LICENSE NUMBER