MEDICARE: PIERRE CLAUDE GILLES 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	208600000X	Surgery Physician	11263	AZ
2	208600000X	Surgery Physician	036058048	IL

General Provider Information

NPI Number	:	1780651737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE CLAUDE GILLES MD

Provider Business Mailing Address
First Line	:	5880 S HOSPITAL DR
Second Line	:
City	:	GLOBE
State	:	AZ
Zip	:	85501-9447
Country	:	US
Telephone Number	:	928-402-1131
Fax Number	:	928-425-7903

Provider Business Practice Location Address
First Line	:	4524 N MARYVALE PKWY
Second Line	:	SUITE 220
City	:	PHOENIX
State	:	AZ
Zip	:	85031-1730
Country	:	US
Telephone Number	:	623-535-4582
Fax Number	:	623-848-4399

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	10/22/2019

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Directions to “ PIERRE CLAUDE GILLES MD” Practice Location

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