Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD029304E | PA |
NPI | 1003843681 |
---|---|
Provider Name | Dr. Alan P Gillick |
First Address | Dickson City, PA 18519-1620 |
Second Address | Dickson City, PA 18519-1620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B34249 | (02) | PA |