1922273614 NPI number — MR. JOSEPH E GILLESPIE M.AUD.

Table of content: MR. JOSEPH E GILLESPIE M.AUD. (NPI 1922273614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922273614 NPI number — MR. JOSEPH E GILLESPIE M.AUD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILLESPIE
Provider First Name:
JOSEPH
Provider Middle Name:
E
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.AUD.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922273614
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 SOUTH PARK CIRCLE
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29407-4680
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-789-1815
Provider Business Mailing Address Fax Number:
843-724-2653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 DOUGHTY ST
Provider Second Line Business Practice Location Address:
SUITE 280
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29403-5736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-958-8877
Provider Business Practice Location Address Fax Number:
843-958-8878
Provider Enumeration Date:
04/24/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  1519 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00934280 . This is a "RAILROAD MC ID-RSFPN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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