Individual
MR. PHILLIP SCOTT GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1509 W TRUMAN RD, INDEPENDENCE, MO 64050-3436
(816) 836-6901
(816) 836-4400
Mailing address
PO BOX 838, SHAWNEE MISSION, KS 66201-0838
(913) 469-4244
(913) 469-1939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2005017775
MO
363AM0700X
Medical Physician Assistant
Primary
2005017775
MO
Other
Enumeration date
10/19/2006
Last updated
07/08/2019
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