Individual
DR. JOHN N GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2711 E PARKWAY DR, RUSSELLVILLE, AR 72802-2006
(479) 968-7302
Mailing address
1235 CAMBRIDGE RD, BENTON, AR 72019-2378
(501) 765-8813
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E2388
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138820001
—
AR
01
—
180046096
RAILROAD MEDICARE
—
Enumeration date
06/12/2006
Last updated
06/12/2019
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