Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | KY25943 | KY |
NPI | 1023084092 |
---|---|
Provider Name | Dr. Hollis R Hilty |
First Address | Lexington, KY 40588 |
Second Address | Lexington, KY 40503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64259435 | (05) | KY |
E01407 | (02) |