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General NPI Number Information
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NPI Number | 1881683720
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Entity Type | Individual
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Provider Name | JASON ANTHONY HILL MED
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 100 MARINERS DR STE D
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City | KINGSLAND
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State | GA
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Zip | 31548-6667
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Country | US
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Telephone | 912-222-3851
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Fax | 912-275-7553
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Provider Business Mailing Address
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Address Line | 147 COLONIAL WAY
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City | BRUNSWICK
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State | GA
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Zip | 31520-2155
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Country | US
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Telephone | 912-222-3851
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Fax | 912-275-7553
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 003437
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License Number State | GA
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