Provider Demographics
NPI:1144574872
Name:GILL FAMILY MEDICINE, P.C.
Entity Type:Organization
Organization Name:GILL FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-355-9040
Mailing Address - Street 1:PO BOX 5750
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-0750
Mailing Address - Country:US
Mailing Address - Phone:256-355-9040
Mailing Address - Fax:256-355-9048
Practice Address - Street 1:2422 DANVILLE RD SW
Practice Address - Street 2:SUITE E
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4220
Practice Address - Country:US
Practice Address - Phone:256-355-9040
Practice Address - Fax:256-355-9048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GILL FAMILY MEDICINE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-02
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty