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General NPI Number Information
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NPI Number | 1952374381
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Entity Type | Individual
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Provider Name | ROBERT THAINE GILLILAND PA
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 1600 PRAIRIE CENTER PKWY
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City | BRIGHTON
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State | CO
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Zip | 80601-4006
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Country | US
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Telephone | 303-458-1600
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Fax | 303-654-8170
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Provider Business Mailing Address
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Address Line | 1241 W MINERAL AVE SUITE 100
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City | LITTLETON
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State | CO
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Zip | 80120-5685
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Country | US
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Telephone | 303-759-0854
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Fax | 303-759-0864
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 104
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License Number State | CO
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