Provider Demographics
NPI:1477061786
Name:VLADIMYR HILAIRE
Entity Type:Organization
Organization Name:VLADIMYR HILAIRE
Other - Org Name:VLADIMYR HILAIRE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMYR
Authorized Official - Middle Name:KUVAROV
Authorized Official - Last Name:HILAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:404-952-6335
Mailing Address - Street 1:8211 BLACKFOOT TRL
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3912
Mailing Address - Country:US
Mailing Address - Phone:404-954-0790
Mailing Address - Fax:
Practice Address - Street 1:8211 BLACKFOOT TRL
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3912
Practice Address - Country:US
Practice Address - Phone:404-952-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-21
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty