Basic Information
| Provider Information | |||||||||
| NPI: | 1790752673 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILMER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | DICKENSON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 238 BARTER DR | ||||||||
| Address2: | |||||||||
| City: | ABINGDON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242102918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766289794 | ||||||||
| FaxNumber: | 2766766612 | ||||||||
| Practice Location | |||||||||
| Address1: | 470 WALDON RD | ||||||||
| Address2: | |||||||||
| City: | ABINGDON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242102206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766289794 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 0101025190 | VA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.