Healthcare Provider Details

I. General information

NPI: 1992723886
Provider Name (Legal Business Name): BERNARD C HILLYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 GINGER WOODS RD
VALLEY NE
68064-9404
US

IV. Provider business mailing address

51 GINGER WOODS RD
VALLEY NE
68064-9404
US

V. Phone/Fax

Practice location:
  • Phone: 402-639-6660
  • Fax: 402-359-2852
Mailing address:
  • Phone: 402-639-6660
  • Fax: 402-359-2852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number21349
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number19980
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: