Basic Information
Provider Information
NPI: 1811934680
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: GREGORY
MiddleName: ALLEN
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6151 S YALE AVE
Address2: SUITE 400
City: TULSA
State: OK
PostalCode: 741361907
CountryCode: US
TelephoneNumber: 9184948500
FaxNumber: 9183075586
Practice Location
Address1: 6151 S YALE AVE
Address2: SUITE 400
City: TULSA
State: OK
PostalCode: 741361907
CountryCode: US
TelephoneNumber: 9184948500
FaxNumber: 9183075586
Other Information
ProviderEnumerationDate: 06/01/2006
LastUpdateDate: 03/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X3165OKY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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