1851363410 NPI number — MR. JAMES HOWARD HILLIS II RPT/ ATC

Table of content: MR. JAMES HOWARD HILLIS II RPT/ ATC (NPI 1851363410)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851363410 NPI number — MR. JAMES HOWARD HILLIS II RPT/ ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILLIS
Provider First Name:
JAMES
Provider Middle Name:
HOWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
II
Provider Credential Text:
RPT/ ATC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851363410
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3005 TIMOTHY WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMOND
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73034-7006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-330-3005
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 W BROOKS ST
Provider Second Line Business Practice Location Address:
RM E8
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73019-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-325-8206
Provider Business Practice Location Address Fax Number:
405-325-8388
Provider Enumeration Date:
02/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251S0007X , with the licence number:  PT1273 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2255A2300X , with the licence number: AT29 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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