Gillis, Douglas Terry
Gillis, Douglas Terry is an individual health care provider with primary practice located at 780 S Walnut St Suite 3, Las Cruces NM 88001-1425. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Gillis, Douglas Terry can be contacted via phone (505) 525-3980.Contact Information
Primary practice address
780 S Walnut St Suite 3
Las Cruces NM 88001-1425
Phone: (505) 525-3980
Fax: (505) 526-8529
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 196 | New Mexico |
Profile Details
| NPI number | 1689667792 |
|---|---|
| LBN Legal business name | Gillis, Douglas Terry |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2005 |
| Last updated | Oct 29th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689667792 | NPPES |
| New Mexico | Other | 0469220001 | DMERC |
| New Mexico | Other | 88001A00Z | DMERC |
| New Mexico | MEDICAID | 52993 | DMERC |
| New Mexico | Other | 16042 | DMERC |
| New Mexico | Other | NM005364 | DMERC |
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