Individual
GEORGE KEITH GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER DR, DECATUR, TX 76234-3834
(940) 626-2410
(940) 626-2411
Mailing address
2901 ACME BRICK PLZ, FORT WORTH, TX 76109-4124
(817) 529-1900
(817) 529-1910
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
R8192
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
394099101
—
TX
01
—
R8192
MEDICAL LICENSE
TX
Enumeration date
04/05/2012
Last updated
12/13/2022
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