Provider Demographics
NPI:1952861452
Name:HILL, JEFFREY J (PEER SUPPORTER)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:J
Last Name:HILL
Suffix:
Gender:M
Credentials:PEER SUPPORTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1791 ALUM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1757
Mailing Address - Country:US
Mailing Address - Phone:614-445-8131
Mailing Address - Fax:
Practice Address - Street 1:137 STETZER RD
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2076
Practice Address - Country:US
Practice Address - Phone:419-562-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001187175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist