John S. Gilliam
Family Doctor Emergency Physician
20172 E Stagecoach Trl
Mayer
, Arizona 86333-2357
John S. Gilliam
Family Doctor Emergency Physician
20172 E Stagecoach Trl
Mayer
, Arizona 86333-2357
(800) 960-4547
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About
Features
Specialties
- Emergency Physician
- Family Doctor
Languages spoken
- English
Location
First Address
- John S. Gilliam
- 15029 N Thompson Peak Parkway Ste B-111 Pmb 438
- Scottsdale, AZ
- Zip : 85260-2223
- Fax : (800) 960-4547
- Phone : (405) 590-8861
Second Address
- John S. Gilliam
- 20172 E Stagecoach Trl
- Mayer, AZ
- Zip : 86333-2357
- Fax : (800) 960-4547
- Phone : (800) 288-6206
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | 16226 | OK |
| Y | 207Q00000X | Family Doctor | 41469 | AZ |
National Provider Identifier
| NPI | 1003877085 |
|---|---|
| Provider Name | John S. Gilliam |
| First Address | Scottsdale, AZ 85260-2223 |
| Second Address | Mayer, AZ 86333-2357 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/03/2006 |
| Last Update Date | 01/07/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100044450A | (05) | OK |
| 100044450B | (05) | OK |
| 600874 | AHCCCS (ARIZONA MEDICAID) ID (01) | AZ |
| E88061 | (02) | OK |
| Z144938 | MEDICARE PTAN (01) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.