Provider Demographics
NPI:1699865329
Name:HILL, JULIE E (OD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:HILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:440-776-8304
Mailing Address - Fax:
Practice Address - Street 1:224 W LORAIN ST STE I
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1087
Practice Address - Country:US
Practice Address - Phone:440-776-8304
Practice Address - Fax:440-776-8328
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5477T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2526136Medicaid
OHV04118Medicare UPIN
OHHI7353311Medicare PIN