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General NPI Number Information
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NPI Number | 1477603579
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Entity Type | Individual
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Provider Name | JOHN WILLIAM GILKEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 55 W MAPLE RD 212
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City | BIRMINGHAM
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State | MI
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Zip | 48009-3303
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Country | US
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Telephone | 248-644-5335
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Fax | 248-205-0010
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Provider Business Mailing Address
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Address Line | 55 W MAPLE RD 212
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City | BIRMINGHAM
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State | MI
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Zip | 48009-3303
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Country | US
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Telephone | 248-644-5335
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Fax | 248-205-0010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 47469
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License Number State | MI
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