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Contact Information

DOUGLAS T GILLIS, DPM
780 S WALNUT ST
SUITE 3
LAS CRUCES, NM88001-1425
 Phone: 505-525-3980
 Fax: 505-526-8529
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DOUGLAS T GILLIS · (Male)

NPI Number 1689667792
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/24/2005
Last updated 10/29/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 196
  • NM Medicaid 52993
  • NM Other NM005364 BC BS
  • NM Other 0469220001 DMERC
  • NM Other 16042 PRESBYTERIAN
  • NM Other 88001A00Z TRICARE WPS
Hospital affiliation(s) Not Available
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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