Provider Demographics
NPI:1356548291
Name:HILLER ORTHOPEDICS
Entity type:Organization
Organization Name:HILLER ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:HILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-885-5588
Mailing Address - Street 1:65-1230 MAMALAHOA HWY
Mailing Address - Street 2:SUITE C-14
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8318
Mailing Address - Country:US
Mailing Address - Phone:808-885-5588
Mailing Address - Fax:808-885-7990
Practice Address - Street 1:65-1230 MAMALAHOA HWY
Practice Address - Street 2:SUITE C-14
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8318
Practice Address - Country:US
Practice Address - Phone:808-885-5588
Practice Address - Fax:808-885-7990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6723207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHHILLERMedicare PIN