Hertzendorf, Jill C

Hertzendorf, Jill C is an individual health care provider with primary practice located at 420 N James Rd , Columbus OH 43219-1834. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Hertzendorf, Jill C can be contacted via phone (614) 257-5200.

Contact Information

Primary practice address
420 N James Rd Columbus OH 43219-1834
Phone: (614) 257-5200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35.056454 Ohio

Profile Details

NPI number 1336102037
LBN Legal business name Hertzendorf, Jill C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2006
Last updated Aug 30th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336102037 NPPES
Ohio Other P00088048 IND RRMEDICARE # AT GRDY
Ohio MEDICAID 0699838 IND RRMEDICARE # AT GRDY
Ohio Other 000000317006 IND RRMEDICARE # AT GRDY

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