Individual
ROBERT THAINE GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1600 PRAIRIE CENTER PKWY, BRIGHTON, CO 80601-4006
(303) 458-1600
(303) 654-8170
Mailing address
1241 W MINERAL AVE, SUITE 100, LITTLETON, CO 80120-5685
(303) 759-0854
(303) 759-0864
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07010408
—
CO
01
—
970016341
RR MEDICARE
CO
Enumeration date
02/08/2006
Last updated
05/11/2009
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