Individual
DR. PHILLIP LEE GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1262
TN
152W00000X
Optometrist
OD1262
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
910711
EYEMED INSURANCE PROVIDER
TN
05
—
Q019840
—
TN
Enumeration date
02/23/2007
Last updated
10/30/2018
Update your record
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