Individual
ETHAN ALEXANDER HILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
(904) 639-8500
Mailing address
2265 KRAFT DR, BLACKSBURG, VA 24060-6360
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.017166
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2020
Last updated
04/30/2024
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