Gillum, John Barton
Gillum, John Barton is an individual health care provider with primary practice located at Madigan Army Medical Ctr 9040 A Reid St, Tacoma WA 98431-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Gillum, John Barton can be contacted via phone (253) 968-1110.Contact Information
Primary practice address
Madigan Army Medical Ctr 9040 A Reid St
Tacoma WA 98431-0001
Phone: (253) 968-1110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 1897 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1897 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA03173 | Texas |
Profile Details
| NPI number | 1699752451 |
|---|---|
| LBN Legal business name | Gillum, John Barton |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2005 |
| Last updated | Jun 4th, 2013 - about 12 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 | 1699752451 | NPPES |
| Kansas | MEDICAID | 200267860A | |
| Kansas | Other | P00231064 | |
| Kansas | MEDICAID | 200039360A | |
| Kansas | MEDICAID | 119732100 | |
| Kansas | MEDICAID | 46883355 | |
| Kansas | MEDICAID | 66478529 | |
| Kansas | MEDICAID | 305251601 |
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