Provider Demographics
NPI:1639116049
Name:HILLYARD, ROBERT FERRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FERRIS
Last Name:HILLYARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-507-3475
Mailing Address - Fax:801-507-3799
Practice Address - Street 1:5169 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6767
Practice Address - Country:US
Practice Address - Phone:801-507-3475
Practice Address - Fax:801-507-3799
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1660901205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTD07608Medicare UPIN
UT000062208Medicare PIN
UT069014006Medicare PIN
UT000063314Medicare PIN