Healthcare Provider Details

I. General information

NPI: 1912097189
Provider Name (Legal Business Name): HILLCREST PEDIATRICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 10/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6559 WILSON MILLS RD BLDG D SUITE 101
MAYFIELD VILLAGE OH
44143-6402
US

IV. Provider business mailing address

6559 WILSON MILLS RD BLDG D SUITE 101
MAYFIELD VILLAGE OH
44143-6402
US

V. Phone/Fax

Practice location:
  • Phone: 440-473-0010
  • Fax: 440-460-2812
Mailing address:
  • Phone: 440-473-0010
  • Fax: 440-460-2812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY HARVEY JINKS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 440-473-0010