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NPI Code Detail

MEDICARE: JILL M SANDERS PA-C

MEDICARE: JILL M SANDERS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician50-001833OH
2363A00000XPhysician Assistant50.001833OH

General Provider Information

NPI Number : 1427051044
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL M SANDERS PA-C
Provider Business Mailing Address
First Line : 3250 MIDDLE URBANA RD
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45502-9285
Country : US
Telephone Number : 937-399-7777
Fax Number : 937-399-6794
Provider Business Practice Location Address
First Line : 204 PATRICK AVE
Second Line :
City : URBANA
State : OH
Zip : 43078-2302
Country : US
Telephone Number : 937-484-6157
Fax Number : 937-484-6181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 02/12/2018

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Directions to “ JILL M SANDERS PA-C” Practice Location

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