Provider Demographics
NPI:1285720821
Name:GILL, JONI MITCHELL (MD)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:MITCHELL
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-4221
Mailing Address - Country:US
Mailing Address - Phone:205-424-6001
Mailing Address - Fax:205-497-9369
Practice Address - Street 1:2201 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-4221
Practice Address - Country:US
Practice Address - Phone:205-424-6001
Practice Address - Fax:205-497-9369
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25543208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL303799382Medicaid
AL303729382Medicaid
AL303749382Medicaid
AL51538993OtherBLUE CROSS BLUE SHIELD
AL51540478OtherBLUE CROSS BLUE SHIELD
AL303709382Medicaid
AL303739382Medicaid
AL303769382Medicaid
AL51538928OtherBLUE CROSS BLUE SHIELD
AL51538931OtherBLUE CROSS BLUE SHIELD
AL51540066OtherBLUE CROSS BLUE SHIELD
AL51538932OtherBLUE CROSS BLUE SHIELD
AL303719382Medicaid
AL51538933OtherBLUE CROSS BLUE SHIELD
AL303709382Medicaid