Gilliam, George Stephen

Gilliam, George Stephen is an individual health care provider with primary practice located at 2200 E Parrish Ave Bldg B, Ste 203, Owensboro KY 42303-1449. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Other Service Providers / Specialist is his primary health care specialty. Gilliam, George Stephen can be contacted via phone (270) 691-9697.

Contact Information

Primary practice address
2200 E Parrish Ave Bldg B, Ste 203 Owensboro KY 42303-1449
Phone: (270) 691-9697
Fax: (270) 691-0485
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 22817 Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X 41068 Kentucky

Profile Details

NPI number 1023016912
LBN Legal business name Gilliam, George Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Jun 19th, 2015 - about 10 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 1023016912 NPPES
Indiana MEDICAID 100329260B
Indiana MEDICAID 64228174
Indiana Other 000000051542
Indiana Other 611303681

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