Healthcare Provider Details

I. General information

NPI: 1164426631
Provider Name (Legal Business Name): JILL EIPPERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 HEALTH PARTNERS CIR
MOUNT ORAB OH
45154-8611
US

IV. Provider business mailing address

5357 ROLLINGWOOD DR
MILFORD OH
45150-3201
US

V. Phone/Fax

Practice location:
  • Phone: 513-981-4707
  • Fax: 513-981-4703
Mailing address:
  • Phone: 513-680-1125
  • Fax: 513-584-1309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35060056
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: