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Contact Information

GARY L FILLMORE, MD
9911 N NEVADA ST STE B
SPOKANE, WA99218
 Phone: 509-484-5710
 Fax: 509-487-1000
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for GARY L FILLMORE · (Male)

NPI Number 1265413769
Status Active
Credentials MD
Entity Individual
Enumeration date 11/10/2005
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • WA License # MD00049255
  • ID Medicaid 808422000
  • WA Medicaid 8509440
  • Other P00642793 RAILROAD MEDICARE
  • WA Other 8949273 CRIME VICTIMS' COMPENSATION
  • WA Other 0239190 DEPT OF LABOR AND INDUSTRIES
  • WA Other G8874801 MEDICARE PTAN
  • WA Other MD00049255 PHYSICIAN AND SURGEON LICENSE
Hospital affiliation(s)
  • COULEE COMMUNITY HOSPITAL - (Critical Access)
    411 FORTUYN ROAD
    GRAND COULEE, WA 99133
  • PROVIDENCE HOLY FAMILY HOSPITAL - (Acute Care)
    5633 NORTH LIDGERWOOD
    SPOKANE, WA 99208
  • PROVIDENCE MOUNT CARMEL HOSPITAL - (Critical Access)
    982 EAST COLUMBIA
    COLVILLE, WA 99114
  • PROVIDENCE SACRED HEART MEDICAL CENTER - (Acute Care)
    101 WEST 8TH AVENUE
    SPOKANE, WA 99204
  • PROVIDENCE ST JOSEPH HOSPITAL - (Critical Access)
    500 EAST WEBSTER
    CHEWELAH, WA 99109
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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