Gilliland, Charles Andrew

Gilliland, Charles Andrew is an individual health care provider with primary practice located at 613 23Rd St Ste G30, Ashland KY 41101-2878. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Gilliland, Charles Andrew can be contacted via phone (606) 327-0036.

Contact Information

Primary practice address
613 23Rd St Ste G30 Ashland KY 41101-2878
Phone: (606) 327-0036
Fax: (606) 329-1159
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 44777 Kentucky
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 24275 West Virginia
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 44777 Kentucky

Profile Details

NPI number 1366646192
LBN Legal business name Gilliland, Charles Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2007
Last updated Nov 17th, 2021 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1366646192 NPPES
Ohio MEDICAID 0053178
Ohio MEDICAID 7100176900

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