Provider Demographics
NPI:1477633451
Name:GILLIES, NEIL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:
Last Name:GILLIES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MCARTHUR BROOK RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05048-9764
Mailing Address - Country:US
Mailing Address - Phone:802-436-3141
Mailing Address - Fax:
Practice Address - Street 1:7 ROPE FERRY RD
Practice Address - Street 2:DARTMOUTH COLLEGE HEALTH SERVICE
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1421
Practice Address - Country:US
Practice Address - Phone:603-646-9400
Practice Address - Fax:603-646-9450
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0055P363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical