Provider Demographics
NPI:1831186295
Name:THILL, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:THILL
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:N2359 SCHACHT RD
Mailing Address - Street 2:THOUSAND HILLS HEALTHCARE, LLC
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-9735
Mailing Address - Country:US
Mailing Address - Phone:715-582-2940
Mailing Address - Fax:715-582-2940
Practice Address - Street 1:N2359 SCHACHT RD
Practice Address - Street 2:THOUSAND HILLS HEALTHCARE, LLC
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-9735
Practice Address - Country:US
Practice Address - Phone:715-582-2940
Practice Address - Fax:715-582-2940
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29899-020207Q00000X
MI4301055360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI080171065OtherRR-MEDICARE
MI0805500191OtherBCBS
WI32295300Medicaid
MIN41200003Medicaid
WI40160Medicare ID - Type Unspecified
WI32295300Medicaid
WI080171065OtherRR-MEDICARE