Provider Demographics
NPI:1801871587
Name:FELDER, JILL D (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:D
Last Name:FELDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7190
Practice Address - Street 1:1 ROSS PARK BLVD STE G-2
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2681
Practice Address - Country:US
Practice Address - Phone:740-314-8523
Practice Address - Fax:740-792-4918
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045133L207R00000X, 207RE0101X, 207RN0300X
OH35.0716385207RN0300X
OH35.071638207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2019569Medicaid
WV3002251000Medicaid
OHH315770Medicare PIN
OH2019569Medicaid
OH2019569Medicaid