Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 43337 | KY |
N | 208600000X | Surgeon | 43337 | KY |
Y | 2086X0206X | Surgical Oncologist | 14316 | NV |
NPI | 1275657207 |
---|---|
Provider Name | Charles Randolph St Hill |
First Address | Las Vegas, NV 89102-1973 |
Second Address | Las Vegas, NV 89102-2351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 31/08/2021 |