Basic Information
Provider Information
NPI: 1386905206
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: LAURA
MiddleName: PAYNTER
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PAYNTER
OtherFirstName: LAURA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 1949 GUNBARREL ROAD
Address2: SUITE 230
City: CHATTANOOGA
State: TN
PostalCode: 37421
CountryCode: US
TelephoneNumber: 4234954349
FaxNumber: 4234954934
Practice Location
Address1: 210 WALMART DRIVE
Address2:  
City: SODDY DAISY
State: TN
PostalCode: 37379
CountryCode: US
TelephoneNumber: 4233326155
FaxNumber: 4233325293
Other Information
ProviderEnumerationDate: 06/07/2012
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X262952MAN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X55836TNY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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