MEDICARE: DR. JOHN M HILLYARD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	168816-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669416129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M HILLYARD M.D.

Provider Business Mailing Address
First Line	:	1899 E MYSTIC GROVE CV
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84093-5509
Country	:	US
Telephone Number	:	801-935-1983
Fax Number	:	385-255-9888

Provider Business Practice Location Address
First Line	:	1899 E MYSTIC GROVE CV
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84093-5509
Country	:	US
Telephone Number	:	801-935-1983
Fax Number	:	385-255-9888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	08/08/2020

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