Provider Demographics
NPI:1669400636
Name:HILL, JERRON C (MD)
Entity type:Individual
Prefix:DR
First Name:JERRON
Middle Name:C
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 MCEWEN RD
Mailing Address - Street 2:SUITE 485
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5112
Mailing Address - Country:US
Mailing Address - Phone:972-980-0500
Mailing Address - Fax:972-980-0503
Practice Address - Street 1:4101 MCEWEN RD
Practice Address - Street 2:SUITE 485
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5112
Practice Address - Country:US
Practice Address - Phone:972-980-0500
Practice Address - Fax:972-980-0503
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4969207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157597903Medicaid
TX157597901Medicaid
TX0A0345Medicare PIN