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GILL MEMORIAL ENT CLINIC PC NPI 1497957419


NPI Information

NPI: 1497957419
Provider Name: GILL MEMORIAL ENT CLINIC, PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
707 S JEFFERSON ST FL 5
ROANOKE, VA
ZIP 24016
Phone: (540) 344-2071
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GILL MEMORIAL ENT CLINIC, PC is a specialist in Roanoke, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GILL MEMORIAL ENT CLINIC, PC NPI is 1497957419. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

707 S JEFFERSON ST FL 5
ROANOKE, VA
ZIP 24016-100
Phone: (540) 344-2071
Fax: (540) 982-8490

The provider's authorized official is Mark R Hanabury .
The authorized official title is Owner and has the following contact phone number (540) 344-2071.

The enumeration date for this NPI number is 6/1/2007 and was last updated on 7/30/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist0101031266VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1143175OTHERVIRGINIAANTHEM
2B07330MEDICARE UPINVIRGINIA
34243474OTHERVIRGINIAAETNA
4243144OTHERVIRGINIASOUTHERN HEALTH
5P00143294OTHERVIRGINIARAILROAD MEDICARE
6CO9151MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAMEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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