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General NPI Number Information
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NPI Number | 1942277280
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Entity Type | Individual
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Provider Name | MARK E GILLESPIE MD
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Gender | Male
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 15640 NEW HAMPSHIRE CT
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City | FORT MYERS
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State | FL
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Zip | 33908-4168
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Country | US
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Telephone | 239-466-2020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-8575
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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 |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 24107
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME148468
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License Number State | FL
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