Individual
JAMES F GILLEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
60 HIGH ST, LEWISTON, ME 04240-7616
(207) 753-3900
Mailing address
60 HIGH ST, LEWISTON, ME 04240-7616
(207) 753-3900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-578
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253800099
—
ME
Enumeration date
09/20/2006
Last updated
02/03/2014
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