Provider Demographics
NPI:1740713031
Name:GILLEY, ANNEMARIE JULIETTE (DO)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:JULIETTE
Last Name:GILLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANNEMARIE
Other - Middle Name:JULIETTE
Other - Last Name:ANGLIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:902 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2724
Mailing Address - Country:US
Mailing Address - Phone:423-664-4460
Mailing Address - Fax:423-664-4466
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:313-562-2942
Practice Address - Fax:319-384-9693
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA99265207VM0101X, 207VX0000X
TN5718207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IADO-05782OtherIOWA BOARD OF MEDICINE
TN5718OtherTENNESSEE BOARD OF OSTEOPATHIC EXAMINATION
GA99265OtherGEORGIA COMPOSITE MEDICAL BOARD