Provider Demographics
NPI:1023060894
Name:HILL, LAWRENCE KING JR (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:KING
Last Name:HILL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LAWRENCE
Other - Middle Name:KING
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6400
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:8 MEMORIAL MEDICAL CT
Practice Address - Street 2:STE. 6
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4455
Practice Address - Country:US
Practice Address - Phone:864-295-1031
Practice Address - Fax:864-269-1639
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13242174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC470587Medicaid
SC470587Medicaid
SC4200Medicare ID - Type Unspecified