Provider Demographics
NPI:1912027731
Name:HIERS, GEORGE MARTIN IV (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MARTIN
Last Name:HIERS
Suffix:IV
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 NE STEPHENS
Mailing Address - Street 2:42
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470
Mailing Address - Country:US
Mailing Address - Phone:541-672-8399
Mailing Address - Fax:541-672-8330
Practice Address - Street 1:1350 NE STEPHENS
Practice Address - Street 2:42
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470
Practice Address - Country:US
Practice Address - Phone:541-672-8399
Practice Address - Fax:541-672-8330
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1597-CS183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3813311OtherNABP