Provider Demographics
NPI:1407190853
Name:DAVID A GILPIN MD PLC
Entity Type:Organization
Organization Name:DAVID A GILPIN MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:GILPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-942-7301
Mailing Address - Street 1:395 WALLACE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4881
Mailing Address - Country:US
Mailing Address - Phone:615-942-7301
Mailing Address - Fax:615-942-8659
Practice Address - Street 1:397 WALLACE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4854
Practice Address - Country:US
Practice Address - Phone:615-942-7301
Practice Address - Fax:615-942-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-23
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48365207Y00000X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530635Medicaid
TN1530635Medicaid