Provider Demographics
NPI:1184822694
Name:HILL, JANA MARIE (DO)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:MARIE
Last Name:HILL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 N BELT HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2410
Mailing Address - Country:US
Mailing Address - Phone:816-271-7077
Mailing Address - Fax:816-271-0421
Practice Address - Street 1:1115 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2410
Practice Address - Country:US
Practice Address - Phone:816-271-7077
Practice Address - Fax:816-271-4998
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010009948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1184822694Medicaid
MO701000301Medicare PIN