Individual
HERBERT YORKIE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-5705
(859) 301-2022
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16374
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0259429
—
OH
05
—
64055734
—
KY
Enumeration date
08/03/2005
Last updated
09/30/2010
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