Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | C8380 | AR |
NPI | 1235197435 |
---|---|
Provider Name | Dr. Joy Wilson Hill |
First Address | Bentonville, AR 72712-4900 |
Second Address | Bentonville, AR 72712-4900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 24/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123409001 | (05) | AR |
F58858 | (02) | AR |