Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 10094322-1205 | UT |
Y | 207QS0010X | Family Doctor - Sports Medicine | MD60984012 | WA |
NPI | 1073900296 |
---|---|
Provider Name | Brian Hill |
First Address | Salt Lake City, UT 84108-1260 |
Second Address | Salt Lake City, UT 84108-1260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2015 |
Last Update Date | 15/01/2021 |