Provider Demographics
NPI:1013024363
Name:GILROY, JAMES H III (MD FACP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:GILROY
Suffix:III
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 496
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:ME
Mailing Address - Zip Code:04054-0496
Mailing Address - Country:US
Mailing Address - Phone:207-646-8386
Mailing Address - Fax:207-641-2855
Practice Address - Street 1:277 POST ROAD
Practice Address - Street 2:
Practice Address - City:MOODY
Practice Address - State:ME
Practice Address - Zip Code:04054
Practice Address - Country:US
Practice Address - Phone:207-646-8386
Practice Address - Fax:207-641-2855
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME011069207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5863011OtherAETNA (PPO)
ME026251OtherANTHEM MAINE
3391849OtherCIGNA
125298OtherAETNA (HMO)
AA6336OtherHARVARD PILGRIM HEALTHCAR
5863011OtherAETNA (PPO)
D78810Medicare UPIN