Individual
KELLY GILMORE
Active
Individual
KELLY GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
M7213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190579602
—
TX
Enumeration date
09/07/2007
Last updated
10/04/2019
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