Individual provider · NPI-1

Dr. Mark A Gillispie, O.D.

Optometrist · Indio, CA

NPI number1043391899
StatusActive
Last updated in NPPESMar 13, 2011

Details

NPI
1043391899
Entity type
Individual (NPI-1)
Name
Dr. Mark A Gillispie
Credential
O.D.
Sex
Male
Sole proprietor
No
Enumeration date
Oct 18, 2006
Last updated
Mar 13, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist8413TCAYes

Practice location

82227 Us Highway 111
Suite B-2
Indio, CA 92201-5667

Phone 760-347-6636 · Fax 760-342-5987

Mailing address

82227 Us Highway 111
Suite B-2
Indio, CA 92201-5667

Phone 760-347-6636 · Fax 760-342-5987

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