MEDICARE: DR. KEVIN GILL M.D.

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	F6665	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F6665	OTHER	TX	M.D.

General Provider Information

NPI Number	:	1427054964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN GILL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-3203
Country	:	US
Telephone Number	:	214-645-0624
Fax Number	:	214-645-0078

Provider Business Practice Location Address
First Line	:	5303 HARRY HINES BLVD FL 6
Second Line	:	SUITE 108
City	:	DALLAS
State	:	TX
Zip	:	75390-8810
Country	:	US
Telephone Number	:	214-645-2225
Fax Number	:	214-645-8451

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	05/10/2017

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Directions to “ DR. KEVIN GILL M.D.” Practice Location

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