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General NPI Number Information
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NPI Number | 1215411624
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Entity Type | Organization
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Legal Business Name | LEAH B. GILLIAM, MD.
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 83 S MAIN ST
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City | LEXINGTON
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State | TN
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Zip | 38351-2109
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Country | US
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Telephone | 731-614-7957
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Fax |
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Provider Business Mailing Address
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Address Line | 83 S MAIN ST
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City | LEXINGTON
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State | TN
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Zip | 38351-2109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | LEAH GILLIAM
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Credential | MD
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Telephone | 731-614-7957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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