Individual
RYAN JAMES GILLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-3000
Mailing address
808 VARSITY DR, TUPELO, MS 38801-4613
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35544
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2022
Last updated
07/02/2025
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