Provider Demographics
NPI:1194760603
Name:DELKER, JILL ROSCOE (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:ROSCOE
Last Name:DELKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:DENISE
Other - Last Name:ROSCOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:724 NW 43RD STREET
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607
Mailing Address - Country:US
Mailing Address - Phone:352-332-7222
Mailing Address - Fax:352-332-7330
Practice Address - Street 1:724 NW 43RD STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-332-7222
Practice Address - Fax:352-332-7330
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92692207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272844300Medicaid
FL272844300Medicaid
FL16222Medicare ID - Type Unspecified
I36466Medicare UPIN