Provider Demographics
NPI:1568664563
Name:JILL OVERCASH LLC
Entity Type:Organization
Organization Name:JILL OVERCASH LLC
Other - Org Name:ALL ABOUT KIDS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:JOWERS
Authorized Official - Last Name:OVERCASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD FAAP
Authorized Official - Phone:678-261-7455
Mailing Address - Street 1:1150 STEEPLE RUN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-4038
Mailing Address - Country:US
Mailing Address - Phone:678-646-0404
Mailing Address - Fax:678-646-0202
Practice Address - Street 1:945 RIVER CENTRE PLACE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:678-646-0404
Practice Address - Fax:678-646-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty