Provider Demographics
NPI:1508673211
Name:HILL, JONATHAN WAYNE
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:WAYNE
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 STATE ROUTE 28 # B-215
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-2199
Mailing Address - Country:US
Mailing Address - Phone:513-549-1169
Mailing Address - Fax:
Practice Address - Street 1:1160 STATE ROUTE 28 STE 8
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-2155
Practice Address - Country:US
Practice Address - Phone:513-994-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator