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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