Provider Demographics
NPI:1134445356
Name:AMBURGEY, HILLARIE SIZEMORE (DPM)
Entity type:Individual
Prefix:DR
First Name:HILLARIE
Middle Name:SIZEMORE
Last Name:AMBURGEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:HILLARIE
Other - Middle Name:LINN
Other - Last Name:SIZEMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1000 MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2404
Mailing Address - Country:US
Mailing Address - Phone:937-493-4659
Mailing Address - Fax:
Practice Address - Street 1:1000 MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2404
Practice Address - Country:US
Practice Address - Phone:937-493-4659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00340213ES0103X
OH36003574213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3133497Medicaid
OH4317651Medicare PIN