Provider Demographics
NPI:1437311180
Name:TRUMBLE, JILL PERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:PERRY
Last Name:TRUMBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:MICHELLE
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:836 E. 65TH STREET
Mailing Address - Street 2:SUITE 20
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-819-7878
Mailing Address - Fax:912-819-3555
Practice Address - Street 1:11706 MERCY BLVD
Practice Address - Street 2:PLAZA A BLDG. 10
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419
Practice Address - Country:US
Practice Address - Phone:912-819-4949
Practice Address - Fax:912-819-2300
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA678212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003134843AMedicaid