Provider Demographics
NPI:1659662773
Name:GILLESPIE, WILLIAM (BS(PHARM))
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:GILLESPIE
Suffix:
Gender:M
Credentials:BS(PHARM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7940 REGATTA DR
Mailing Address - Street 2:APT #102
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-1342
Mailing Address - Country:US
Mailing Address - Phone:770-880-8523
Mailing Address - Fax:
Practice Address - Street 1:1640 CENTURY CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-8822
Practice Address - Country:US
Practice Address - Phone:901-384-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000034388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist