Provider Demographics
NPI:1487765665
Name:HILL, G PERRY (PHD)
Entity type:Individual
Prefix:DR
First Name:G
Middle Name:PERRY
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7330 FERN AVE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105
Mailing Address - Country:US
Mailing Address - Phone:318-629-0152
Mailing Address - Fax:318-629-0157
Practice Address - Street 1:7330 FERN AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105
Practice Address - Country:US
Practice Address - Phone:318-629-0152
Practice Address - Fax:318-629-0157
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA472103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist