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NPI Code Detail

MEDICARE: DR. SHAUN J. GILLIS M.D.

MEDICARE:  DR. SHAUN J. GILLIS  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
1207V00000XObstetrics & Gynecology Physician10375MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000099115OTHERBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265465207
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAUN J. GILLIS M.D.
Provider Business Mailing Address
First Line : 915 HIGHLAND BLVD
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-6902
Country : US
Telephone Number : 406-414-5000
Fax Number :
Provider Business Practice Location Address
First Line : 905 HIGHLAND BLVD STE 4500
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-6903
Country : US
Telephone Number : 406-414-5150
Fax Number : 406-414-5175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 04/10/2025

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Directions to “ DR. SHAUN J. GILLIS M.D.” Practice Location

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