Provider Demographics
NPI:1982607958
Name:GILLESPIE, JAMES EARNEST (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EARNEST
Last Name:GILLESPIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:17 N MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2344
Mailing Address - Country:US
Mailing Address - Phone:540-213-7720
Mailing Address - Fax:540-213-7728
Practice Address - Street 1:425 S LINDEN AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3505
Practice Address - Country:US
Practice Address - Phone:540-213-7720
Practice Address - Fax:540-949-0545
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030015207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180019580OtherRAILROAD MEDICARE
VA006301631Medicaid
VA059573OtherBLUE CROSS BLUE SHIELD
VA006301631Medicaid
B05712Medicare UPIN