Provider Demographics
NPI:1467609131
Name:GILL, YOGESHWAR S (MD)
Entity Type:Individual
Prefix:DR
First Name:YOGESHWAR
Middle Name:S
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GARRY
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1611 MCARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2532
Mailing Address - Country:US
Mailing Address - Phone:931-728-9340
Mailing Address - Fax:931-728-9343
Practice Address - Street 1:1611 MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2532
Practice Address - Country:US
Practice Address - Phone:931-728-9340
Practice Address - Fax:931-728-9343
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44100207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine