Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CPO02850 | VA |
N | 222Z00000X | Podiatrist | CPO02850 | VA |
Y | 224P00000X | Prosthetist | CPO02850 | VA |
NPI | 1073613725 |
---|---|
Provider Name | Mr. Jeremy Hillard |
First Address | Nashville, TN 37212-2637 |
Second Address | Nashville, TN 37212-2637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 03/10/2008 |