Individual
DR. NATHAN STEPHEN GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5582
Mailing address
811 WEDGEWOOD CT, BRANDON, MS 39047-6366
(601) 992-2773
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-1889
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02704891
—
MS
05
—
1356123
—
LA
Enumeration date
06/18/2007
Last updated
03/23/2009
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