Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4312 | KY |
NPI | 1003014531 |
---|---|
Provider Name | Dr. Stuart Allen Hill |
First Address | Bowling Green, KY 42104-5821 |
Second Address | Bowling Green, KY 42104-5821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000062737 | BLUE CROSS BLUE SHIELD (01) | KY |
U63236 | (02) | KY |