| Jai H.gilliam, M.d. , Pllc | |
|
1782 Bryan Station Rd Lexington KY 40505-2133 | |
| (859) 294-0077 | |
| (859) 294-0078 |
| Full Name | Jai H.gilliam, M.d. , Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 1782 Bryan Station Rd, Lexington, Kentucky |
| Authorized Official Name and Position | Jai Herman Gilliam (PHYSICIAN) |
| Authorized Official Contact | 8592940077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jai H.gilliam, M.d. , Pllc 1782 Bryan Station Rd Lexington KY 40505-2133 Ph: (859) 294-0077 | Jai H.gilliam, M.d. , Pllc 1782 Bryan Station Rd Lexington KY 40505-2133 Ph: (859) 294-0077 |
| NPI Number | 1245488964 |
|---|---|
| Provider Enumeration Date | 09/05/2008 |
| Last Update Date | 09/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245488964 | NPI | - | NPPES |
| 64111156 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 39604 (Kentucky) | Primary |
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