Individual
RODNEY N GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
80 B VETERANS BLVD, ACOMA, NM 87034
(505) 552-5300
(505) 552-5490
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5300
(505) 552-5490
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
6929T
CA
152W00000X
Optometrist
Primary
8301949-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3450
—
NM
Enumeration date
07/27/2006
Last updated
07/21/2022
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