Provider Demographics
NPI:1144750225
Name:HILLIARY, SHERRI DENISE
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:DENISE
Last Name:HILLIARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 ROSS STREET LN
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1887
Mailing Address - Country:US
Mailing Address - Phone:407-437-3912
Mailing Address - Fax:
Practice Address - Street 1:5854 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206-5209
Practice Address - Country:US
Practice Address - Phone:407-437-3012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management