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1992807077
JACK LEROY GILLILAND
STOCKTON, CA
NPI
1992807077
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: CA G15491)
Enumeration Date
2006-09-01
Last Update Date
2007-07-08
Business Address
Dr. JACK LEROY GILLILAND M.D.
7373 WEST LN
STOCKTON, CA 95210-3377
Phone number: 209-476-3346
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Mailing Address
Dr. JACK LEROY GILLILAND M.D.
325 W TADDEI RD
ACAMPO, CA 95220-9654
Phone number: 209-334-1424
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