Provider Demographics
NPI:1932166089
Name:HILL, MARVIN E III (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:E
Last Name:HILL
Suffix:III
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 1:1760 E PECOS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-3201
Mailing Address - Country:US
Mailing Address - Phone:480-553-8999
Mailing Address - Fax:480-553-8989
Practice Address - Street 1:1760 E PECOS RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-3201
Practice Address - Country:US
Practice Address - Phone:480-553-8999
Practice Address - Fax:480-553-8989
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ511772085R0202X
NM96-2722085R0202X
TXE96952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ075643Medicaid
NML7738Medicaid