Individual
DR. JOHN A GILLEN II
Active
Individual
DR. JOHN A GILLEN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
110898
MO
207X00000X
Orthopaedic Surgery Physician
30353
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17519026
BCBS GROUP #
MO
05
—
208537613
—
MO
05
—
208537621
—
KS
05
—
208537639
—
MO
01
—
23296023
BCBS INDIVIDUAL #
MO
01
—
607374400
DEPT OF LABOR
MO
Enumeration date
06/01/2005
Last updated
02/27/2012
Update your record
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