Provider Demographics
NPI:1538248380
Name:HILD, KENNETH A (PA-C)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:A
Last Name:HILD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:KENNETH
Other - Middle Name:ANDREW
Other - Last Name:HILD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:479 THOMAS JONES WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2552
Mailing Address - Country:US
Mailing Address - Phone:610-280-9999
Mailing Address - Fax:610-594-0392
Practice Address - Street 1:479 THOMAS JONES WAY STE 300
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2552
Practice Address - Country:US
Practice Address - Phone:610-280-9999
Practice Address - Fax:610-594-0392
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002991L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant