Jay, Rodney Gillman

Jay, Rodney Gillman is an individual health care provider with primary practice located at 450 E Main St , Rexburg ID 83440-2048. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Jay, Rodney Gillman can be contacted via phone (208) 356-3691.

Contact Information

Primary practice address
450 E Main St Rexburg ID 83440-2048
Phone: (208) 356-3691
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 5298339-1205 Utah
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 5298339-1205 Utah
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X M-12527 Idaho

Profile Details

NPI number 1225201148
LBN Legal business name Jay, Rodney Gillman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2008
Last updated Apr 13th, 2020 - 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 1225201148 NPPES
Utah MEDICAID 1225201148

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