Provider Demographics
NPI:1518494509
Name:HILLEGASS, EVANGELINE (MD)
Entity type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:
Last Name:HILLEGASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVANGELINE
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4186 CORTLAND DR
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:PA
Mailing Address - Zip Code:15554-7706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4186 CORTLAND DR
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:PA
Practice Address - Zip Code:15554-7706
Practice Address - Country:US
Practice Address - Phone:814-839-4108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD470640207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine