Gilliam, David Edward
Gilliam, David Edward is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Gilliam, David Edward can be contacted via phone (601) 815-5300.Contact Information
Primary practice address
2500 N State St
Jackson MS 39216-4500
Phone: (601) 815-5300
Fax: (601) 984-6665
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 21947 | Mississippi |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 21947 | Mississippi |
Profile Details
| NPI number | 1720217367 |
|---|---|
| LBN Legal business name | Gilliam, David Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2009 |
| Last updated | Oct 25th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720217367 | NPPES |
| Mississippi | Other | P01713170 | RAILROAD MEDICARE PTAN |
| Mississippi | MEDICAID | 04321325 | RAILROAD MEDICARE PTAN |
| Mississippi | MEDICAID | 2406841 | RAILROAD MEDICARE PTAN |
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