MEDICARE: S P GILL MD PC

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
1	261QM2500X	Medical Specialty Clinic/Center	21571	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110115313	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0344310	OTHER	AZ	BLUE CROSS

General Provider Information

NPI Number	:	1366621930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S P GILL MD PC

Provider Business Mailing Address
First Line	:	14815 N DEL WEBB BLVD
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2145
Country	:	US
Telephone Number	:	623-977-3300
Fax Number	:	623-977-6808

Provider Business Practice Location Address
First Line	:	14815 N DEL WEBB BLVD
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2145
Country	:	US
Telephone Number	:	623-977-3300
Fax Number	:	623-977-6808

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SUSAN ALLEN
Credential	:
Telephone Number	:	480-478-5557

Provider Enumeration Date	:	10/30/2007
Last Update Date	:	08/05/2025

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Directions to “S P GILL MD PC ” Practice Location

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