Provider Demographics
NPI:1992723886
Name:HILLYER, BERNARD C (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:C
Last Name:HILLYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 GINGER WOODS RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:NE
Mailing Address - Zip Code:68064-9404
Mailing Address - Country:US
Mailing Address - Phone:402-639-6660
Mailing Address - Fax:402-359-2852
Practice Address - Street 1:51 GINGER WOODS RD
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:NE
Practice Address - Zip Code:68064-9404
Practice Address - Country:US
Practice Address - Phone:402-639-6660
Practice Address - Fax:402-359-2852
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21349207QG0300X
IA19980207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7122424Medicaid
IA7122424Medicaid
IAI15821Medicare ID - Type Unspecified
NEP00078016Medicare ID - Type UnspecifiedRAILROAD MEDICARE NUMBER