DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SCOTT R GILLUM, PA

Active

SCOTT R GILLUM, PA is a Surgical Physician Assistant healthcare provider located in SHREVEPORT, Louisiana. NPI 1114003076 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · SHREVEPORT, LA

Registration Details

NPI Number
1114003076
Provider Type
Individual
Gender
Male
NPI Issued
Oct 31, 2006 (19.74470229414 yrs)
Last Updated
Jul 14, 2021
License
PA200106 (LA)

Practice Information

Address
7925 YOUREE DR
SUITE 200
SHREVEPORT, LA, 711055127
Browse LA providers · Browse ZIP 71105
Phone
3182123610
Fax
3182123672
Primary Specialty
Surgical Physician Assistant
363AS0400X

Other Surgical Physician Assistant Providers in SHREVEPORT, LA

Name Credential NPI
CHARLES GIRARD TISDALE PA-C 1821096686
SHERRY B WALKER PA 1669442133
PAUL BRYANT MCHALFFEY PA-C 1720041312
STAFFORD R LONG PA-C 1851343396
MARY EMILY MAY 1528082781
MS. MARIBETH FORREST P.A.-C 1235220708
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.