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Individual

CHARLES P GILLESPIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2849 CRATER LAKE LN, LAFAYETTE, CO 80026-3488
(520) 260-3478
Mailing address
2849 CRATER LAKE LN, LAFAYETTE, CO 80026-3488
(520) 260-3478

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
042.0012577
VT
207P00000X
Emergency Medicine Physician
40833
AZ
207P00000X
Emergency Medicine Physician
48971
CO
207P00000X
Emergency Medicine Physician
MD2015-0100
NM
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
16455
NV
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
27906
NE
208000000X
Pediatrics Physician
0048971
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
76686
RESIDENT PG PERMIT
AZ
Enumeration date
06/18/2007
Last updated
01/31/2024
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