Provider Demographics
NPI:1639206659
Name:GILLASPIE, MARK W (RPH)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:W
Last Name:GILLASPIE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5122 S XENOPHON CT
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1529
Mailing Address - Country:US
Mailing Address - Phone:303-979-0551
Mailing Address - Fax:303-861-3333
Practice Address - Street 1:5122 S XENOPHON CT
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-1529
Practice Address - Country:US
Practice Address - Phone:303-979-0551
Practice Address - Fax:303-861-3333
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO11512207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
014650OtherKAISER-COMMERCIAL NUMBER