Individual
DR. MARTIN J GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 HOSPITAL AVE, SUITE 311, DU BOIS, PA 15801-1462
(814) 375-3750
(814) 375-9624
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-3750
(814) 375-9624
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD053745L
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD053745L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019812840001
—
PA
Enumeration date
08/10/2006
Last updated
09/28/2011
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