Provider Demographics
NPI:1831440577
Name:HILL, GRANT D (OD)
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:D
Last Name:HILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15933 CLAYTON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2172
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:4109 UNION RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1064
Practice Address - Country:US
Practice Address - Phone:314-487-0700
Practice Address - Fax:314-487-1212
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1729152W00000X
MO2016026607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist