Provider Demographics
NPI:1770526188
Name:HILTON, NATHAN EARL (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:EARL
Last Name:HILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 METRO BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3086
Mailing Address - Country:US
Mailing Address - Phone:952-920-4915
Mailing Address - Fax:952-915-6091
Practice Address - Street 1:215 IVY ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3000
Practice Address - Country:US
Practice Address - Phone:218-828-7585
Practice Address - Fax:218-828-7588
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN602282085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400283767Medicare PIN
TX920004640Medicare UPIN
TX82829NMedicare PIN
TX84Z164Medicare PIN
TXG89494Medicare UPIN
TX103101502Medicaid
TX103101501Medicaid