Provider Demographics
NPI:1568581668
Name:AMARILLO CRITICAL CARE SERVICES,P.A.
Entity Type:Organization
Organization Name:AMARILLO CRITICAL CARE SERVICES,P.A.
Other - Org Name:WILLIAM GILL, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-968-0937
Mailing Address - Street 1:26423 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1248
Mailing Address - Country:US
Mailing Address - Phone:410-968-0937
Mailing Address - Fax:410-968-2240
Practice Address - Street 1:26423 BURTON AVE
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1248
Practice Address - Country:US
Practice Address - Phone:410-968-0937
Practice Address - Fax:410-968-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015715208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD352239-01OtherBCBS OF MARYLAND
MDR872-0001OtherBCBS BLUE CHOICE
MD816580OtherMDIPA & OPTIMUM CHOICE
MD0101147OtherUNITED HEALTH CARE
MD99833OtherCOVENTRY
MDP14270OtherBCBS POINT OF SERVICE