Provider Demographics
NPI:1598783730
Name:NEFF, JILL A (DO)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:A
Last Name:NEFF
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 1:504 MCCARTY LN
Mailing Address - Street 2:PO BOX 959
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-7019
Mailing Address - Country:US
Mailing Address - Phone:740-418-0642
Mailing Address - Fax:
Practice Address - Street 1:504 MCCARTY LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-7019
Practice Address - Country:US
Practice Address - Phone:740-418-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.003758208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0572287Medicaid