Healthcare Provider Details
I. General information
NPI: 1144725003
Provider Name (Legal Business Name): JEREMY LOUIS HILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/23/2018
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 E WENDOVER AVE STE 310
GREENSBORO NC
27401-1231
US
IV. Provider business mailing address
301 E WENDOVER AVE STE 310
GREENSBORO NC
27401-1231
US
V. Phone/Fax
- Phone: 336-832-3070
- Fax:
- Phone: 336-832-3075
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0008X |
| Taxonomy | Neuromuscular Medicine (Psychiatry & Neurology) Physician |
| License Number | 2023-00028 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 202300028 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: