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Individual

MELISSA ARON GILLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1501 KINGS HWY, DEPARTMENT OF EMERGENCY MEDICINE, SHREVEPORT, LA 71103-4228
(318) 675-6632
Mailing address
1549 E 70TH ST STE 300, SHREVEPORT, LA 71105-5056
(318) 300-3898
(318) 797-4241

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.A10382
LA
363AM0700X
Medical Physician Assistant
PA10382RX
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1626309
LA
Enumeration date
07/28/2006
Last updated
10/16/2025
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