Provider Demographics
NPI:1780770909
Name:HILL, DAVID R (M D)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:HILL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4378
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39304-4378
Mailing Address - Country:US
Mailing Address - Phone:601-483-4821
Mailing Address - Fax:601-485-8727
Practice Address - Street 1:1415 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-5345
Practice Address - Country:US
Practice Address - Phone:601-483-4821
Practice Address - Fax:601-485-8727
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS115822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115116Medicaid
MS00115116Medicaid
MSD89885Medicare UPIN