Healthcare Provider Details

I. General information

NPI: 1578540241
Provider Name (Legal Business Name): JAMES STEWART GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 N MOUNT VERNON DR
IOWA CITY IA
52245-3715
US

IV. Provider business mailing address

313 N MOUNT VERNON DR
IOWA CITY IA
52245-3715
US

V. Phone/Fax

Practice location:
  • Phone: 319-341-0770
  • Fax:
Mailing address:
  • Phone: 319-341-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01076970A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35047
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: