Healthcare Provider Details

I. General information

NPI: 1811950678
Provider Name (Legal Business Name): JILL BETH D'AMICO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILL WILLIAMS

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 PARK DR
PALMYRA PA
17078-3445
US

IV. Provider business mailing address

7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

V. Phone/Fax

Practice location:
  • Phone: 717-838-6305
  • Fax:
Mailing address:
  • Phone: 570-837-2123
  • Fax: 570-837-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS010698L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: