Provider Demographics
NPI:1245612258
Name:CARA GILLILAND OD, LLC
Entity Type:Organization
Organization Name:CARA GILLILAND OD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLILAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-789-5367
Mailing Address - Street 1:106 EUCLID DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-7916
Mailing Address - Country:US
Mailing Address - Phone:205-789-5367
Mailing Address - Fax:
Practice Address - Street 1:6275 UNIVERSITY DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1776
Practice Address - Country:US
Practice Address - Phone:256-922-0992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C80-TA-929152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-32592OtherBLUE CROSS
AL102I416798Medicare UPIN