Basic Information
| Provider Information | |||||||||
| NPI: | 1184822694 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | JANA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1115 N BELT HWY | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645062410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162717077 | ||||||||
| FaxNumber: | 8162710421 | ||||||||
| Practice Location | |||||||||
| Address1: | 1115 N BELT HWY | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645062410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162717077 | ||||||||
| FaxNumber: | 8162714998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 11/21/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2010009948 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1184822694 | 05 | MO | MEDICAID |