Individual
DR. TOM M GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20701 N SCOTTSDALE RD, UNIT 107 SUITE 196, SCOTTSDALE, AZ 85255-6413
(480) 247-6301
(480) 247-6301
Mailing address
20701 N SCOTTSDALE RD, UNIT 107 SUITE 196, SCOTTSDALE, AZ 85255-6413
(480) 247-6301
(480) 247-6301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35983
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35983
ARIZONA MEDICAL BOARD
AZ
Enumeration date
11/04/2010
Last updated
11/04/2010
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