Provider Demographics
NPI:1366545790
Name:HILL, LESTER H II (DO)
Entity type:Individual
Prefix:
First Name:LESTER
Middle Name:H
Last Name:HILL
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16474 ST CLAIR AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:E LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920
Mailing Address - Country:US
Mailing Address - Phone:330-386-1111
Mailing Address - Fax:330-386-1263
Practice Address - Street 1:16474 ST CLAIR AVE
Practice Address - Street 2:SUITE A
Practice Address - City:E LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920
Practice Address - Country:US
Practice Address - Phone:330-386-1111
Practice Address - Fax:330-386-1263
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0743548Medicaid
H10633491Medicare ID - Type Unspecified
OH0743548Medicaid