Organization
JOHN A. GILLEN II MD ORTHOPAEDIC SPECIALISTS P.A.
Active
Organization
JOHN A. GILLEN II MD ORTHOPAEDIC SPECIALISTS P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A GILLEN II M.D. (PRESIDENT)
(816) 331-6700
Entity
Organization
Contact information
Practice address
900 MAIN ST, GRANDVIEW, MO 64030-2477
(816) 331-6700
(816) 876-2399
Mailing address
PO BOX 412043, KANSAS CITY, MO 64141-2043
(913) 647-4102
(913) 647-4122
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17519026
BCBSKC GROUP #
MO
01
—
DC5878
RR MEDICARE GROUP #
MO
Enumeration date
09/11/2007
Last updated
10/12/2007
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