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NPI Code Detail

MEDICARE: MRS. MARY CAROLYN GILKINSON MSR, SLP

MEDICARE: MRS. MARY CAROLYN GILKINSON MSR, SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist3986SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003844341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY CAROLYN GILKINSON MSR, SLP
Provider Business Mailing Address
First Line : 1 INDEPENDENCE PT
Second Line : SUITE 212
City : GREENVILLE
State : SC
Zip : 29615-4545
Country : US
Telephone Number : 864-797-6307
Fax Number :
Provider Business Practice Location Address
First Line : 29 N ACADEMY ST
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2629
Country : US
Telephone Number : 864-331-1380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 03/13/2018

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