Provider Demographics
NPI:1144216672
Name:HOSKING, JILL KATHLEEN (DPM)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:KATHLEEN
Last Name:HOSKING
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4751 OBERLIN AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3401
Mailing Address - Country:US
Mailing Address - Phone:440-282-1312
Mailing Address - Fax:
Practice Address - Street 1:4751 OBERLIN AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3401
Practice Address - Country:US
Practice Address - Phone:440-282-1312
Practice Address - Fax:440-282-1319
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003142213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2131491Medicaid
OH4761660001Medicare NSC
OHU64760Medicare UPIN
OHADSP00582Medicare ID - Type Unspecified
OH2131491Medicaid