Henry K Hillman, MD

Individual provider Active NPI General Practice Physician · Cimarron, NM

NPI 1235224403 · NPPES record last updated Jul 16, 2008

Key facts

NPI
1235224403
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
9049 (NM)
Practice address
9TH and Washington BLDG 356 C
Cimarron Health Care Clinic
Cimarron, NM 87714
Phone
(505) 376-2402
Fax
(505) 376-2107
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9049NMMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 9049 NM Yes

Addresses

Primary practice location

9TH and Washington BLDG 356 C
Cimarron Health Care Clinic
Cimarron, NM 87714

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers

IdentifierTypeStateIssuer
6931MedicaidNM

Other providers in Cimarron, NM

All providers in Cimarron, NM · General Practice Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.