Provider Demographics
NPI:1164426631
Name:EIPPERT, JILL (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:EIPPERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5357 ROLLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-3201
Mailing Address - Country:US
Mailing Address - Phone:513-680-1125
Mailing Address - Fax:513-584-1309
Practice Address - Street 1:154 HEALTH PARTNERS CIR
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8611
Practice Address - Country:US
Practice Address - Phone:513-981-4707
Practice Address - Fax:513-981-4703
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35060056207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0802135Medicaid
IN200105120Medicaid
KY64962095Medicaid
OH930019366Medicare PIN
OHE99375Medicare UPIN
IN200105120Medicaid