Provider Demographics
NPI:1730346776
Name:JERRON HILL, MD, PA
Entity type:Organization
Organization Name:JERRON HILL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENATIVE/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRON
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-437-4801
Mailing Address - Street 1:4101 MCEWEN RD
Mailing Address - Street 2:485
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5112
Mailing Address - Country:US
Mailing Address - Phone:972-980-0503
Mailing Address - Fax:972-980-0503
Practice Address - Street 1:5601 GLENVIEW LN
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-3723
Practice Address - Country:US
Practice Address - Phone:972-668-7460
Practice Address - Fax:972-668-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A0345Medicare PIN