Organization
DR GARY L GILLEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY LEE GILLEN MD (OWNER SOLE PROPRIETOR)
(740) 420-9288
Entity
Organization
Contact information
Practice address
131 LEWIS AVE, CIRCLEVILLE, OH 43113
(740) 420-9288
(740) 420-3070
Mailing address
PO BOX 39, 131 LEWIS AVE, CIRCLEVILLE, OH 43113
(740) 420-9288
(740) 420-3070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GA9339531
MEDICARE
OH
Enumeration date
07/16/2007
Last updated
07/16/2007
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