Provider Demographics
NPI:1578507190
Name:GILMOUR, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GILMOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WESTBOROUGH STATE HOSPITAL
Mailing Address - Street 2:LYMAN STREET
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-0288
Mailing Address - Country:US
Mailing Address - Phone:508-616-2279
Mailing Address - Fax:
Practice Address - Street 1:LYMAN ST
Practice Address - Street 2:WESTBOROUGH STATE HOSPITAL
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-0288
Practice Address - Country:US
Practice Address - Phone:508-616-2279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA368212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3038611Medicaid
MA3038611Medicaid
MAB96999Medicare UPIN