Provider Demographics
NPI:1922088343
Name:OVERCASH, JILL J (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:J
Last Name:OVERCASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 RIVERSIDE PARKWAY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043
Mailing Address - Country:US
Mailing Address - Phone:678-646-0404
Mailing Address - Fax:678-646-0202
Practice Address - Street 1:2000 RIVERSIDE PARKWAY
Practice Address - Street 2:SUITE 207
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
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA051340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000955974AMedicaid
GA37BBGGMMedicare ID - Type Unspecified