Individual
GILLES BASTILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1040 GLENN BLVD SW, FT PAYNE, AL 35967-8413
(256) 845-6900
(256) 845-6911
Mailing address
1040 GLENN BLVD SW, FT PAYNE, AL 35967-8413
(256) 845-6900
(256) 845-6911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00009111
AL
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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