Basic Information
Provider Information
NPI: 1750332078
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILLYER
FirstName: RONALD
MiddleName: WAYNE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 121 NORTH 20TH STREET # 18
Address2: P.O. BOX 2125
City: OPELIKA
State: AL
PostalCode: 368032125
CountryCode: US
TelephoneNumber: 3347498303
FaxNumber: 3347455243
Practice Location
Address1: 121 NORTH STREET # 18
Address2:  
City: OPELIKA
State: AL
PostalCode: 368015457
CountryCode: US
TelephoneNumber: 3347498303
FaxNumber: 3347455243
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 02/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0105X00007332ALY Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand

ID Information
IDTypeStateIssuerDescription
51034745HIL01ALBLUECROSS & BLUE SHIELDOTHER
00003474505AL MEDICAID
00003474605AL MEDICAID
00009856505AL MEDICAID
51034746HIL01ALBLUE CROSS & BLUE SHIELDOTHER


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