Gillett, Richard Clark

Gillett, Richard Clark is an individual health care provider with primary practice located at 1800 10Th Ave , Columbus GA 31901-1513. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gillett, Richard Clark can be contacted via phone (706) 571-1120.

Contact Information

Primary practice address
1800 10Th Ave Columbus GA 31901-1513
Phone: (706) 571-1120
Fax: (706) 571-1603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 034142 Georgia

Profile Details

NPI number 1134113277
LBN Legal business name Gillett, Richard Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2005
Last updated Aug 29th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134113277 NPPES
Georgia Other 52324760 001 BCBS
Georgia MEDICAID 000459258E BCBS
Georgia Other 080154745 BCBS

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