David Edward Gilliam

M.D. | Pediatrics | Male

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Complete Profile:

David Edward Gilliam basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics
Provider Name :	David Edward Gilliam
Credential :	M.D.
Gender :	Male

Business Address:

David Edward Gilliam address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	2500 N State St Jackson, MS, 39216-4500 United States
Phone Number :	601-815-5300
Fax Number :	601-984-6665

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1720217367
NPI Entity Type :	Individual
First Enrolment Date :	03 Jul, 2009
Last Updated On :	25 Oct, 2016

Medicare Participation:

David Edward Gilliam participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	2264687037
Medicare Enrollment ID :	I20130227000506
Primary Specialty :	Pediatric Medicine
Medical School :	University Of Alabama School Of Medicine
Graduation Year :	2009
Accepts Medicare?	Yes. David Edward Gilliam accepts medicare insurance.

Group Practice Association:

David Edward Gilliam is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which David Edward Gilliam is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
State Of Mississippi - University Of Mississippi Medical Center	1850293036	828	2500 N State St Jackson, MS - 392164500	Yes
State Of Mississippi - University Of Mississippi Medical Center	1850293036	828	1010 Lakeland Pl Flowood, MS - 392326678 Ph: 6018152005	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for David Edward Gilliam are as mentioned. Primary taxonomy code for David Edward Gilliam, M.D. is 208000000X (Pediatrics).

Taxonomy Code	Speciality	Primary	License No.	State
207R00000X	Internal Medicine	No	21947	MS
208000000X	Pediatrics	Yes	21947	MS

Legacy Identifiers:

Other legacy medical identifiers of David Edward Gilliam such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
04321325	MEDICAID	MS
2406841	MEDICAID	LA
P01713170	Other	MS	RAILROAD MEDICARE PTAN

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	2500 N State St Jackson, MS, 39216-4500 United States
Phone Number :	601-815-5300
Fax Number :	601-984-6665

Business Location:

Patients can refer following map for directions to David Edward Gilliam practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.