Individual
DR. JOHN ANDERSON GILLIAM II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
607 WELCH ST, SILVERTON, OR 97381
(508) 873-3636
(503) 873-1457
Mailing address
607 WELCH ST, SILVERTON, OR 97381
(508) 873-3636
(503) 873-1457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD21293
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151306
—
OR
Enumeration date
07/14/2006
Last updated
07/08/2007
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