Larry S Gilliam M.D.

NPI 1053346130 - Anesthesiology - 207L00000X

NPI Details
NPI 1053346130
Gender Male
Enumeration Date 07/11/2006
Last Updated 01/30/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
415 S 28TH AVE
HATTIESBURG MS, 39401-7246, US
Phone (601) 261-3606
Fax (601) 579-5383
Business Location
415 S 28TH AVE
HATTIESBURG MS, 39401-7246, US
Phone (601) 579-5463
Fax (601) 579-5240
Toxanomy
Taxonomy Code 207L00000X
License State Mississippi
License Number 10665
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According to our database, Dr. Larry S Gilliam M.D. NPI is 1053346130, taxonomy code is 207L00000X and license number is 10665, license state is located at Mississippi. Larry S Gilliam M.D. physically located at 415 S 28th Ave, Hattiesburg MS, 39401-7246. NPI Number Larry S Gilliam M.D. has the Individual type.

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1053346130 NPI number is provided on an as is basis without warranty of any kind. 1053346130 is maintained by the National Plan & Provider Enumeration System. The contents of Larry S Gilliam M.D. are for informational purposes only.