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NPI Code Detail

MEDICARE: BRYAN JAMES PIMLOTT M.D.

MEDICARE: BRYAN JAMES PIMLOTT 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
1207X00000XOrthopaedic Surgery Physician32940AZ
2207X00000XOrthopaedic Surgery Physician036153704IL

General Provider Information

NPI Number : 1396761318
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN JAMES PIMLOTT M.D.
Provider Business Mailing Address
First Line : 1005 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-2834
Country : US
Telephone Number : 217-223-8400
Fax Number :
Provider Business Practice Location Address
First Line : 4800 MAINE ST
Second Line :
City : QUINCY
State : IL
Zip : 62305-5875
Country : US
Telephone Number : 217-214-0444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/04/2024

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