| John S Gilliam, MD | |
|
20172 E Stagecoach Trl, Mayer, AZ 86333-2357 | |
| (800) 288-6206 | |
| (800) 960-4547 |
| Full Name | John S Gilliam |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 39 Years |
| Location | 20172 E Stagecoach Trl, Mayer, Arizona |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003877085 | NPI | - | NPPES |
| 100044450B | Medicaid | OK | |
| 600874 | Other | AZ | AHCCCS (ARIZONA MEDICAID) ID |
| Z144938 | Other | AZ | MEDICARE PTAN |
| 100044450A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 16226 (Oklahoma) | Secondary |
| 207Q00000X | Family Medicine | 41469 (Arizona) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carelock Llc | 9436491172 | 10 |
| Carelock Llc | 9436491172 | 10 |
| Entity Name | Carelock Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245795459 PECOS PAC ID: 9436491172 Enrollment ID: O20190823000616 |
| Mailing Address | Practice Location Address |
|---|---|
| John S Gilliam, MD 15029 N Thompson Peak Parkway, Ste B-111 Pmb 438, Scottsdale, AZ 85260-2223 Ph: (405) 590-8861 | John S Gilliam, MD 20172 E Stagecoach Trl, Mayer, AZ 86333-2357 Ph: (800) 288-6206 |
Natalie Noel Oakley, FNP-C Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 14600 S Waterberry St, Mayer, AZ 86333 Phone: 928-271-5490 | |
Dr. Zachary Thomas Brown, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 20172 E Stagecoach Trl, Mayer, AZ 86333 Phone: 928-632-4399 | |
Leanna Drake, FNP-C Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 20172 E Stagecoach Trl, Mayer, AZ 86333 Phone: 928-632-4399 |