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General NPI Number Information
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NPI Number | 1780879858
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Entity Type | Organization
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Legal Business Name | JOHN A. GILLEN II MD ORTHOPAEDIC SPECIALISTS P.A.
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 900 MAIN ST
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City | GRANDVIEW
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State | MO
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Zip | 64030-2477
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Country | US
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Telephone | 816-331-6700
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Fax | 816-876-2399
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Provider Business Mailing Address
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Address Line | PO BOX 412043
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City | KANSAS CITY
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State | MO
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Zip | 64141-2043
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Country | US
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Telephone | 913-647-4102
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Fax | 913-647-4122
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A GILLEN II
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Credential | M.D.
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Telephone | 816-331-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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