Provider Demographics
NPI:1477560050
Name:GILMORE, JAMES C (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:GILMORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:611 ALCORN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9323
Mailing Address - Country:US
Mailing Address - Phone:662-665-4660
Mailing Address - Fax:662-665-4645
Practice Address - Street 1:611 ALCORN DR STE 200
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9323
Practice Address - Country:US
Practice Address - Phone:662-665-4660
Practice Address - Fax:662-665-4645
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL25354208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009934175Medicaid
AL51517796OtherBCBS
AL51517796OtherBCBS
ALC36413Medicare UPIN