Individual
MICHAEL PAUL GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2686
(740) 356-8117
(740) 353-1214
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-8681
(740) 356-1256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.007812RX
OH
363AS0400X
Surgical Physician Assistant
Primary
50.007812RX
OH
Other
Enumeration date
11/16/2022
Last updated
06/16/2023
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