Provider Demographics
NPI:1023018595
Name:KERR, JILL E (DO)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:E
Last Name:KERR
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:4530 E RAY RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6094
Mailing Address - Country:US
Mailing Address - Phone:480-940-5420
Mailing Address - Fax:480-940-5480
Practice Address - Street 1:4530 E RAY RD
Practice Address - Street 2:SUITE 190
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6094
Practice Address - Country:US
Practice Address - Phone:480-940-5420
Practice Address - Fax:480-940-5480
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2017-07-03
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Provider Licenses
StateLicense IDTaxonomies
AZ3241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264581170OtherOCEAN SHORE FAMILY MEDICAL CENTER
AS860950956OtherTAX ID
AZD41470Medicare UPIN
AS860950956OtherTAX ID