Provider Demographics
NPI:1629034061
Name:HILL, JAMES KOREY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:KOREY
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 MONTGOMERY RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2385
Mailing Address - Country:US
Mailing Address - Phone:513-489-7457
Mailing Address - Fax:513-247-2142
Practice Address - Street 1:11340 MONTGOMERY ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249
Practice Address - Country:US
Practice Address - Phone:513-489-7457
Practice Address - Fax:513-247-2142
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069249H207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2021092Medicaid
KY64957368Medicaid
G48769Medicare UPIN
OH110157400Medicare PIN
KY64957368Medicaid