Provider Demographics
NPI:1538180203
Name:HILL, GARY RONALD (R, NM)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:RONALD
Last Name:HILL
Suffix:
Gender:M
Credentials:R, NM
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Mailing Address - Street 1:670 HIGHWAY 225 E
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:AR
Mailing Address - Zip Code:72058-9744
Mailing Address - Country:US
Mailing Address - Phone:501-581-1865
Mailing Address - Fax:
Practice Address - Street 1:2585 DONAGHEY AVE
Practice Address - Street 2:STE S-109
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-2327
Practice Address - Country:US
Practice Address - Phone:501-764-1201
Practice Address - Fax:501-764-1204
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
190481247100000X, 2471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology