SCOTT R GILLUM

SHREVEPORT, LA
NPI1114003076
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: LA  PA200106)
Enumeration Date2006-10-31
Last Update Date2021-07-14
Business Address
SCOTT R GILLUM PA
7925 YOUREE DR SUITE 200
SHREVEPORT, LA 71105-5127
Phone number: 318-212-3610
Mailing Address
SCOTT R GILLUM PA
7925 YOUREE DR SUITE 200
SHREVEPORT, LA 71105-5127
Phone number: 318-212-3610
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