Individual
MR. BRENT DOUGLASS GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPAS
Contact information
Practice address
7801 ACADEMY RD NE, ALBUQUERQUE, NM 87109-3379
(505) 272-2700
(505) 272-2760
Mailing address
7801 ACADEMY RD NE, ALBUQUERQUE, NM 87109-3379
(505) 272-2700
(505) 272-2760
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2017-0067
NM
Other
Enumeration date
09/10/2017
Last updated
07/13/2023
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