Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | DR.0035962 | CO |
NPI | 1043278492 |
---|---|
Provider Name | William Martin Hilty |
First Address | Grand Junction, CO 81501-8209 |
Second Address | Grand Junction, CO 81501-8209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 22/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110169411 | RAILROAD (01) | CO |
1359629 | (05) | CO |
G23463 | (02) | CO |
T0052 | (05) | UT |