Provider Demographics
NPI:1255514584
Name:HILL, JEREMY (MD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5801 PINEHURST BYROMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31070-6907
Mailing Address - Country:US
Mailing Address - Phone:229-276-3348
Mailing Address - Fax:229-276-3382
Practice Address - Street 1:902 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-3234
Practice Address - Country:US
Practice Address - Phone:229-276-3348
Practice Address - Fax:229-276-3382
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0603812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology