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NPI Code Detail

MEDICARE: DR. MATTHEW CHARLES GILL M.D.

MEDICARE: DR. MATTHEW CHARLES GILL 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
1207L00000XAnesthesiology Physician60082241WA
2207L00000XAnesthesiology Physician55476TN
3207L00000XAnesthesiology Physician9261078ID
42083A0100XAerospace Medicine Physician054379GA

General Provider Information

NPI Number : 1699822833
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW CHARLES GILL M.D.
Provider Business Mailing Address
First Line : PO BOX 171181
Second Line :
City : MEMPHIS
State : TN
Zip : 38187-1181
Country : US
Telephone Number : 901-682-6828
Fax Number :
Provider Business Practice Location Address
First Line : 5545 MURRAY AVE STE 130
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-3861
Country : US
Telephone Number : 901-682-6828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 11/14/2024

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