Individual
DR. GEORGE STEPHEN GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 E PARRISH AVE, BLDG B, STE 203, OWENSBORO, KY 42303-1449
(270) 691-9697
(270) 691-0485
Mailing address
2200 E PARRISH AVE, BLDG B, STE 203, OWENSBORO, KY 42303-1449
(270) 691-9697
(270) 691-0485
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22817
KY
208600000X
Surgery Physician
41068
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051542
BS OF KY
KY
05
—
100329260B
—
IN
01
—
611303681
COMMERCIAL INSURANCE
KY
05
—
64228174
—
KY
Enumeration date
07/13/2005
Last updated
06/19/2015
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