Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DS3811 | TN |
NPI | 1386862035 |
---|---|
Provider Name | James Albert Gillcrist |
First Address | Nashville, TN 37243 |
Second Address | Nashville, TN 37243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |