Basic Information
| Provider Information | |||||||||
| NPI: | 1629099544 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STUART A HILL DC PSC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HILL CHIROPRACTIC OFFICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1212 ASHLEY CIR | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421045821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707811310 | ||||||||
| FaxNumber: | 2707811359 | ||||||||
| Practice Location | |||||||||
| Address1: | 1212 ASHLEY CIR | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421045821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707811310 | ||||||||
| FaxNumber: | 2707811359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HILL | ||||||||
| AuthorizedOfficialFirstName: | STUART | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2707811310 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DC | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 4312 | KY | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
ID Information
| ID | Type | State | Issuer | Description | 000000062737 | 01 | KY | BLUE CROSS BLUE SHIELD | OTHER |