ROBERT L. GILLUM JR. (NPI# 1922190271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922190271 |
| Entity Type | Individual |
| Full Name | ROBERT L. GILLUM JR. |
| Practice Address |
6099 Adaughtery Rd Suite A Long Beach MS 39560 |
| Mailing Address |
6099a Daughtery Rd #a Long Beach MS 39560 |
| Practice Telephone | 2285473976 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2017-04-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427192368 | Robert Blackford Gillum IIi | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| Street Address |
6099 ADAUGHTERY RD SUITE A |
| City | LONG BEACH |
| State | MS |
| Zip Code | 39560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1760889554 | Laura Catherine Ranson | Physical Therapist | 2 Tower Plaz, Suite B, Community Rehab Center, Long Beach, MS 39560 | 2014-11-24 |
| 1073803714 | Kathleen Ann Williams | Pharmacist | Riteaid #7227 Pharmacy 200 West Railroad St, Suite B, Long Beach, MS 39560 | 2011-04-14 |
| 1609177179 | Robert William Wylie | Hearing Instrument Specialist | 100 Larosa Rd, Ste D, Long Beach, MS 39560 | 2010-11-15 |
| 1891026498 | James Paul Bertinato | Speech-Language Pathologist | 20337 Longview Rd, Long Beach, MS 39560 | 2010-01-21 |
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1932362324 | Family Physical Therapy of South Ms LLC | Physical Therapist | 100-a La Rosa Rd, Long Beach, MS 39560 | 2008-07-07 |
| 1952589863 | Miller-whitmer Family Chiropractic | Chiropractor | 125 Jeff Davis Avenue, Long Beach, MS 39560 | 2008-02-01 |
| 1528267333 | Rachel S Conrad Md PC | Family Medicine | 100a Larosa, Long Beach, MS 39560 | 2007-07-12 |
| 1386720241 | Betty Diane Edrington | Registered Nurse | 2 Tower Plaza, Pineville Road, Long Beach, MS 39560 | 2006-10-31 |
| Find all providers in zip 39560 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487769386 | Tricia Manalastas | Physician Assistant | 2888 Long Beach Blvd., Suite 180, Long Beach, CA 90807 | 2006-08-20 |
| 1639604960 | Tiffany Worthington | Physician Assistant | 3828 Schaufele Ave Ste 340, Long Beach, CA 90808 | 2017-04-24 |
| 1255621694 | Makell Charles Murphy | Physician Assistant | 3828 Schaufele Ave, Suite 340, Long Beach, CA 90808-1791 | 2011-04-18 |
| 1275574709 | Anastasia Marie Anderson | Physician Assistant | 2888 Long Beach Blvd, Suite 240, Long Beach, CA 90806-1530 | 2006-06-08 |
| 1295734150 | William M Turner Jr. | Physician Assistant | 3828 Schaufele Ave Ste 340, Long Beach, CA 90808-1793 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1114392172 | Robin Rae Hoffeld | Physician Assistant | 11401 Wedgewood Ln, Ocean Springs, MS 39564-7910 | 2015-12-02 |
| 1487027504 | Advanced Surgical Assistants LLC | Physician Assistant | 1924 30th Ave Ste A, Gulfport, MS 39501-4534 | 2015-11-11 |
| 1063889509 | Julie Dianne Sullivan | Physician Assistant | 216 Linda Dr, Ocean Springs, MS 39564-4114 | 2015-09-01 |
| 1326478744 | William Bishop | Physician Assistant | 11476 Savannah Pl, Gulfport, MS 39503-1109 | 2013-11-21 |
| 1376840173 | Christopher Lawrence Sweebe | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2011-02-15 |
| 1528275633 | Tina M Mcginty | Physician Assistant | 250 Church Ave, Gulfport, MS 39507-1255 | 2007-05-17 |
| 1841249489 | Bradley Martin | Physician Assistant | 1014 Biglane Drive, Brookhaven, MS 39601 | 2006-05-10 |
| 1144293655 | David Bradley Robbins | Physician Assistant | 206 Oxford Rd, New Albany, MS 38652-3115 | 2006-02-07 |
| 1801877022 | Benjamin P Watts | Physician Assistant | 3615 Hospital St, Pascagoula, MS 39581-4112 | 2005-11-07 |
| Find all providers with the same taxonomy | ||||
| City | LONG BEACH |
| Zip Code | 39560 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.