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Individual
BRUCE DEVIN GILLILAND
Active
Individual
BRUCE DEVIN GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
1593
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010168864
—
VA
05
—
3941143
—
TN
01
—
4102823
BLUE CROSS BLUE SHILED
TN
05
—
77620342
—
KY
01
—
P00317714
RAILROAD MEDICARE
TN
Enumeration date
07/11/2005
Last updated
06/13/2014
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