Provider Demographics
NPI:1821098120
Name:MARKS, JILL R (PT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:R
Last Name:MARKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:R
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:55 COBURG RD
Mailing Address - Street 2:SLOCUM ORTHOPEDICS PC
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2433
Mailing Address - Country:US
Mailing Address - Phone:541-485-8111
Mailing Address - Fax:541-342-6379
Practice Address - Street 1:55 COBURG RD
Practice Address - Street 2:SLOCUM ORTHOPEDICS PC
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2433
Practice Address - Country:US
Practice Address - Phone:541-485-8111
Practice Address - Fax:541-342-6379
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR38092251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR019867Medicaid
OR116607Medicare ID - Type Unspecified
OR116607Medicare PIN
ORP42573Medicare UPIN