Gilliam, Edwin

Gilliam, Edwin is an individual health care provider with primary practice located at 1775 E Skyline Dr Ste 101, Tucson AZ 85718-1162. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Gilliam, Edwin can be contacted via phone (520) 615-6200.

Contact Information

Primary practice address
1775 E Skyline Dr Ste 101 Tucson AZ 85718-1162
Phone: (520) 615-6200
Fax: (520) 615-6255
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN085103 Arizona

Profile Details

NPI number 1952383143
LBN Legal business name Gilliam, Edwin
Credentials Family Physician (FP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Jul 13th, 2026 - about 3 months 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 1952383143 NPPES
Arizona MEDICAID 416083

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