Individual
DR. JOHN B GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7850 CAMARGO RD, CINCINNATI, OH 45243-2652
(513) 561-5655
(513) 561-2319
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-0001
(513) 585-5505
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-025979
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117224
—
OH
01
—
180031749
RAILROAD MEDICARE
OH
Enumeration date
03/17/2006
Last updated
11/20/2017
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