Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 1481 | MT |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 1481 | MT |
N | 208D00000X | General Practice Physician | 4090 | MT |
NPI | 1184780421 |
---|---|
Provider Name | Dr. Mackay Joseph Hull |
First Address | Billings, MT 59101-4227 |
Second Address | Billings, MT 59101-4227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 24/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04-2887 | (05) | MT |
05577 | DENTIST (01) | IA |
102867700 | TITLE XIX - INDIVIDUAL (01) | WY |
1053 | PIN (01) | |
10530 | BLUE CROSS BLUE SHIELD (01) | MT |
112397100 | TITLE XIX - GROUP (01) | WY |
1161 | DENTIST (01) | WY |
12-5437 | (05) | MT |
1481 | DENTIST (01) | MT |
4090 | MEDICAL DOCTOR (01) | MT |
4368 | DENTIST (01) | NE |
AH7378309 | DEA (01) | |
D20617 | (02) |