1396786687 NPI number — DR. THOMAS MICHAEL HILLMAN MD

Table of content: DR. THOMAS MICHAEL HILLMAN MD (NPI 1396786687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396786687 NPI number — DR. THOMAS MICHAEL HILLMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILLMAN
Provider First Name:
THOMAS
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1396786687
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE FRANCISCAN WAY
Provider Second Line Business Mailing Address:
STE 280
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45408-1470
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-424-5470
Provider Business Mailing Address Fax Number:
937-424-5486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE FRANCISCAN WAY
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45408-1470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-424-5470
Provider Business Practice Location Address Fax Number:
937-424-5486
Provider Enumeration Date:
06/09/2006

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: 207RG0300X , with the licence number:  35043710 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000315755 . This is a "BCBS PROVIDER ID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3401019811 . This is a "CLIA ID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 35043710 . This is a "OHIO STATE LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: HO9337121 . This is a "HOMECAREDOCTORS MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0408795 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2431827 . This is a "HOMECARE DOCTORS MEDICAID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 04-09086 . This is a "UHC PROVIDER ID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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