Provider Demographics
NPI:1497733919
Name:HILL, JOEL R (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:R
Last Name:HILL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:R
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-826-9180
Mailing Address - Fax:608-833-0999
Practice Address - Street 1:1102 S PARK ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1714
Practice Address - Country:US
Practice Address - Phone:608-263-3111
Practice Address - Fax:608-263-6663
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2655-23363A00000X
WI2655-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1497733919Medicaid
WI742250098Medicare Oscar/Certification
Q67327Medicare UPIN