Provider Demographics
NPI:1912097189
Name:HILLCREST PEDIATRICS INC.
Entity Type:Organization
Organization Name:HILLCREST PEDIATRICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HARVEY
Authorized Official - Last Name:JINKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-473-0010
Mailing Address - Street 1:6559 WILSON MILLS RD
Mailing Address - Street 2:BLDG D SUITE 101
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-6402
Mailing Address - Country:US
Mailing Address - Phone:440-473-0010
Mailing Address - Fax:440-460-2812
Practice Address - Street 1:6559 WILSON MILLS RD
Practice Address - Street 2:BLDG D SUITE 101
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-6402
Practice Address - Country:US
Practice Address - Phone:440-473-0010
Practice Address - Fax:440-460-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2011-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0227892Medicaid