Provider Demographics
NPI:1770894362
Name:HILL, JEFFREY (DO)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 CREEKSIDE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3540
Mailing Address - Country:US
Mailing Address - Phone:916-983-2307
Mailing Address - Fax:916-983-8528
Practice Address - Street 1:1743 CREEKSIDE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3540
Practice Address - Country:US
Practice Address - Phone:916-983-2307
Practice Address - Fax:916-983-8528
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11015694A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine