Gilliam, Blake Hamilton

Gilliam, Blake Hamilton is an sole proprietor health care provider with primary practice located at 1230 Slaughter Rd Ste C , Madison AL 35758-5901. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Gilliam, Blake Hamilton can be contacted via phone (256) 325-0955.

Contact Information

Primary practice address
1230 Slaughter Rd Ste C Madison AL 35758-5901
Phone: (256) 325-0955
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 1-153719 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1-153719 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 1-153719 Alabama

Profile Details

NPI number 1043845787
LBN Legal business name Gilliam, Blake Hamilton
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 3rd, 2020
Last updated Mar 3rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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