Individual
CHARLES MCCLELLAND GILL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2018019483
MO
208800000X
Urology Physician
MD19748
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0092790
BLUE CROSS
TN
05
—
3044902
—
TN
01
—
340013304
RR MEDICARE
TN
Enumeration date
01/25/2006
Last updated
06/16/2026
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