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Individual

JAMES WINSTON GILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 725-1226
(540) 857-5306

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005190
VA
363AS0400X
Surgical Physician Assistant
Primary
0110005190
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427415058
TRICARE
VA
01
14274150585
OPTIMA HEALTH PLAN
VA
Enumeration date
01/27/2016
Last updated
08/17/2016
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