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NPI Code Detail

MEDICARE: DR. DAVID M GILDER M.D.

MEDICARE:  DR. DAVID M GILDER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMS 9705MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225099922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID M GILDER M.D.
Provider Business Mailing Address
First Line : 965 RIDGE LAKE BLVD STE 103
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-9446
Country : US
Telephone Number : 901-227-3255
Fax Number : 901-227-8591
Provider Business Practice Location Address
First Line : 823 GRAND AVE
Second Line :
City : YAZOO CITY
State : MS
Zip : 39194-3233
Country : US
Telephone Number : 662-751-8289
Fax Number : 662-751-8279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 03/07/2018

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Directions to “ DR. DAVID M GILDER M.D.” Practice Location

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