| Theopolis Gilliam Jr, MD | |
|
702 N Main St, Emporia, VA 23847-1242 | |
| (434) 594-6603 | |
| (804) 765-6651 |
| Full Name | Theopolis Gilliam Jr |
|---|---|
| Gender | Male |
| Speciality | Gastroenterology |
| Experience | 42 Years |
| Location | 702 N Main St, Emporia, Virginia |
| 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 |
|---|---|---|---|
| 1174566558 | NPI | - | NPPES |
| 187123 | Other | VA | BLUE SHIELD |
| 6919392 | Other | CIGNA | |
| 005818613 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 0101041278 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southern Virginia Regional Medical Center | Emporia, VA | Hospital |
| Southside Regional Medical Center | Petersburg, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bon Secours Medical Group Richmond Specialty Care Llc | 8022440056 | 355 |
| Entity Name | Bon Secours Medical Group Richmond Specialty Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477112225 PECOS PAC ID: 8022440056 Enrollment ID: O20191113002170 |
| Mailing Address | Practice Location Address |
|---|---|
| Theopolis Gilliam Jr, MD 8580 Magellan Pkwy, Richmond, VA 23227-1149 Ph: (804) 765-6650 | Theopolis Gilliam Jr, MD 702 N Main St, Emporia, VA 23847-1242 Ph: (434) 594-6603 |
Fitzgerald Marcelin Sr., MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 702 N Main St, Emporia, VA 23847 Phone: 434-634-7723 Fax: 434-634-7725 | |
Dr. Wynne V Legrow, M.D. Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 201 Weaver Ave, Emporia, VA 23847 Phone: 434-634-9488 Fax: 434-348-1094 |