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General NPI Number Information
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NPI Number | 1720143696
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Entity Type | Individual
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Provider Name | GILLIAN JOSEPHINE STUART M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1490 PARK AVE NW STE 4B
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City | NORTON
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State | VA
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Zip | 24273-1631
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Country | US
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Telephone | 276-439-1463
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 W OAKLAND AVE STE 310
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2192
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Country | US
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Telephone | 423-952-2111
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Fax | 423-282-1657
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | TP913
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | N8463
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | N8463
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 40681
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101250864
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License Number State | VA
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