Provider Demographics
NPI:1114633245
Name:HILL, JEFFERY GASTON
Entity Type:Individual
Prefix:
First Name:JEFFERY
Middle Name:GASTON
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MISSISSIPI AVE SE
Mailing Address - Street 2:#229
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032
Mailing Address - Country:US
Mailing Address - Phone:240-868-2311
Mailing Address - Fax:
Practice Address - Street 1:5110 A ST SE # A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6442
Practice Address - Country:US
Practice Address - Phone:202-424-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care