MEDICARE: DR. CHRIS L GILLESPIE MD

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
1	207R00000X	Internal Medicine Physician	8810	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1699776658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRIS L GILLESPIE MD

Provider Business Mailing Address
First Line	:	2095 EXETER RD
Second Line	:	SUITE 80-266
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-3963
Country	:	US
Telephone Number	:	901-844-1434
Fax Number	:	901-844-1439

Provider Business Practice Location Address
First Line	:	1861 OLD TOWNE LN
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-6411
Country	:	US
Telephone Number	:	901-844-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	09/04/2014

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