MEDICARE: CHRISTOPHER GILLESPIE 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
1	207Q00000X	Family Medicine Physician	A75846	CA

General Provider Information

NPI Number	:	1881645265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GILLESPIE M.D.

Provider Business Mailing Address
First Line	:	801 W CENTER AVE
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-6013
Country	:	US
Telephone Number	:	559-791-7049
Fax Number	:	559-734-1247

Provider Business Practice Location Address
First Line	:	1107 W POPLAR AVE
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-5839
Country	:	US
Telephone Number	:	559-781-7242
Fax Number	:	559-782-8259

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	12/14/2011

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