Individual
DR. STEPHEN R GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 863-7607
(205) 437-5998
Mailing address
PO BOX 88452, CHICAGO, IL 60680-1452
(205) 437-6098
(205) 437-5998
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME82778
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059187377
BCBS PROVIDER NUMBER
AL
01
—
059189324
BCBS PROVIDER NUMBER
AL
05
—
269107800
—
FL
01
—
78881
BCBS PROVIDER NUMBER
FL
01
—
P00723096
RAILROAD MEDICARE
FL
Enumeration date
05/03/2006
Last updated
08/06/2009
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