Provider Demographics
NPI:1912998030
Name:HILLMAN, JASON PAUL (DO)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:PAUL
Last Name:HILLMAN
Suffix:
Gender:M
Credentials:DO
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 3039
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-3039
Mailing Address - Country:US
Mailing Address - Phone:540-374-5200
Mailing Address - Fax:540-374-1164
Practice Address - Street 1:418 CHATHAM SQUARE OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2561
Practice Address - Country:US
Practice Address - Phone:540-374-5200
Practice Address - Fax:540-374-1164
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201700207Q00000X
NC200500055207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1912998030Medicaid
SCNC1070Medicaid
NC5913008Medicaid
NC1912998030Medicaid
NC2403204BMedicare PIN
NC2403204GMedicare PIN
NC2403204Medicare PIN
NC2403204HMedicare PIN
NC2403204JMedicare PIN
NC2403204NMedicare PIN
SCAA48197772Medicare PIN
NC5913008Medicaid
NC2403204FMedicare PIN
NC2403204LMedicare PIN
NC2403204MMedicare PIN
NCNC7163AMedicare PIN
NC2403204DMedicare PIN
VAD000Medicare UPIN
NCNC7163BMedicare PIN
NCNC7163CMedicare PIN
SCNC1070Medicaid
NCNC7163DMedicare PIN
NC2403204AMedicare PIN
NC2403204KMedicare PIN
NC2403204EMedicare PIN
SCAA48195042Medicare PIN