Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 12852 | AZ |
Y | 208600000X | Surgeon | 12852 | AZ |
NPI | 1023014016 |
---|---|
Provider Name | Dr. Scott J Hillmann |
First Address | Phoenix, AZ 85032-3356 |
Second Address | Phoenix, AZ 85032-3356 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 18/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020040211 | RR MEDICARE (01) | |
211524 | (05) | AZ |
2572623 | AETNA (01) | AZ |
2Z0573 | HEALTHNET (01) | AZ |
AZ0830700 | BLUE CROSS BLUE SHIELD (01) | AZ |
C99644 | (02) | AZ |