Individual
JAMES R GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
7244 E VIRGINIA ST, EVANSVILLE, IN 47715-4068
(812) 476-1377
(812) 476-1288
Mailing address
7244 E VIRGINIA ST, EVANSVILLE, IN 47715-4068
(812) 476-1377
(812) 476-1288
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12009709
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12009709
STATE LICENSE
IN
01
—
163651
CSHC
IN
Enumeration date
05/04/2007
Last updated
07/08/2007
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