MEDICARE: DR. JERRON C HILL MD

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
1	207L00000X	Anesthesiology Physician	L4969	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669400636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRON C HILL MD

Provider Business Mailing Address
First Line	:	4101 MCEWEN RD
Second Line	:	SUITE 485
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75244-5112
Country	:	US
Telephone Number	:	972-980-0500
Fax Number	:	972-980-0503

Provider Business Practice Location Address
First Line	:	4101 MCEWEN RD
Second Line	:	SUITE 485
City	:	FARMERS BRANCH
State	:	TX
Zip	:	75244-5112
Country	:	US
Telephone Number	:	972-980-0500
Fax Number	:	972-980-0503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	05/19/2015

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