Provider Demographics
NPI:1952973588
Name:HILL, DEREK LYNN (MAT, ATC)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:M
Credentials:MAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 LIBERTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:DIERKS
Mailing Address - State:AR
Mailing Address - Zip Code:71833-9572
Mailing Address - Country:US
Mailing Address - Phone:870-784-5153
Mailing Address - Fax:
Practice Address - Street 1:4656 N, AR-7
Practice Address - Street 2:M
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-2502
Practice Address - Country:US
Practice Address - Phone:501-984-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer