Provider Demographics
NPI:1861425787
Name:HILL, CHARLES SMITH (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:SMITH
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4171 SNAPFINGER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3412
Mailing Address - Country:US
Mailing Address - Phone:404-284-8288
Mailing Address - Fax:404-284-0557
Practice Address - Street 1:4171 SNAPFINGER WOODS DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3412
Practice Address - Country:US
Practice Address - Phone:404-284-8288
Practice Address - Fax:404-284-0557
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA026307207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00287251CMedicaid
GAD45648Medicare UPIN