Provider Demographics
NPI:1619960945
Name:GILSON, THOMAS M (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:GILSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CLEARWATER DRIVE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105
Mailing Address - Country:US
Mailing Address - Phone:207-781-7900
Mailing Address - Fax:207-781-2900
Practice Address - Street 1:98 CLEARWATER DRIVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-7900
Practice Address - Fax:207-781-2900
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1763204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM7302OtherMEDICARE ID - GROUP
MM7221Medicare UPIN
MEMM9385Medicare Oscar/Certification
H60646Medicare UPIN