Provider Demographics
NPI:1801357702
Name:HILL, JEFFREY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 GOLDEN POND DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6140
Mailing Address - Country:US
Mailing Address - Phone:405-406-3148
Mailing Address - Fax:
Practice Address - Street 1:500 N MERIDIAN AVE STE 108A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-5700
Practice Address - Country:US
Practice Address - Phone:405-406-3148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty