Provider Demographics
NPI:1932108248
Name:HILL, JOHN D (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:HILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2730
Mailing Address - Country:US
Mailing Address - Phone:419-228-5512
Mailing Address - Fax:419-228-1160
Practice Address - Street 1:1034 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2730
Practice Address - Country:US
Practice Address - Phone:419-228-5512
Practice Address - Fax:419-228-1160
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2848T486152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000116639OtherANTHEM PROVIDER NUMBER
OH0147970001OtherMEDICARE DMERC
OH0130398Medicaid
OHT46224Medicare UPIN
OH000000116639OtherANTHEM PROVIDER NUMBER