MEDICARE: HILLCREST PEDIATRICS INC.

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	208000000X	Pediatrics Physician

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

General Provider Information

NPI Number	:	1912097189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLCREST PEDIATRICS INC.

Provider Business Mailing Address
First Line	:	6559 WILSON MILLS RD
Second Line	:	BLDG D SUITE 101
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-6402
Country	:	US
Telephone Number	:	440-473-0010
Fax Number	:	440-460-2812

Provider Business Practice Location Address
First Line	:	6559 WILSON MILLS RD
Second Line	:	BLDG D SUITE 101
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-6402
Country	:	US
Telephone Number	:	440-473-0010
Fax Number	:	440-460-2812

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY HARVEY JINKS
Credential	:	M.D.
Telephone Number	:	440-473-0010

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	10/30/2011

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Practice Location Address:

6559 WILSON MILLS RD , SUITE 106
MAYFIELD VILLAGE, OH
44143-6402

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Practice Fax: 440-460-2833

Directions to “HILLCREST PEDIATRICS INC. ” Practice Location

Language	Start Address	Practice Location

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