Individual
DR. JILL E MCEACHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1499 KENNEDY RD STE A, TIFTON, GA 31794-4177
(229) 382-0467
(229) 382-8714
Mailing address
PO BOX 1295, TIFTON, GA 31793-1295
(229) 382-0467
(229) 382-8714
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO11764
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00923469
—
GA
01
—
724756
UNITED CONCORDIA
GA
01
—
910233
BCBS
GA
05
—
9184128
—
GA
Enumeration date
11/06/2006
Last updated
07/09/2007
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