Individual
CHARLES M GILL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 PATIENTS FIRST DR STE 3400, WASHINGTON, MO 63090
(636) 239-5155
Mailing address
901 PATIENTS FIRST DR STE 3400, WASHINGTON, MO 63090-4700
(636) 239-5155
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
08/02/2018
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