Individual
GEORGE GILLESPIE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
50 PARKWAY LN, PETAL, MS 39465-3035
(601) 544-7404
(601) 584-6457
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19284
MS
207Q00000X
Family Medicine Physician
Primary
19284
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029455
CIGNA
MS
05
—
05020034
—
MS
01
—
6039505
HEALTHSPRING
MS
01
—
9864055
AETNA
MS
Enumeration date
10/11/2006
Last updated
03/07/2023
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