Provider Demographics
NPI:1235111733
Name:GILKISON, WILLIAM MINOR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MINOR
Last Name:GILKISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E COUNTY LINE ROAD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1070
Mailing Address - Country:US
Mailing Address - Phone:317-883-4736
Mailing Address - Fax:317-884-0732
Practice Address - Street 1:701 E COUNTY LINE ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1070
Practice Address - Country:US
Practice Address - Phone:317-883-4736
Practice Address - Fax:317-884-0732
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01022746A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INB28183Medicare UPIN
IN139550Medicare ID - Type Unspecified
IN065940SSSMedicare PIN