Mark a Gillispie O D INC

NPI #1053492744 in Indio, California

Provider Information

NPI Number: 1053492744
Entity Type: Organization
Organization Name: Mark a Gillispie O D INC
Primary Specialty: Optometrist
Enumeration Date: Oct 18, 2006
Last Updated: Nov 3, 2009

Practice Location

Address: 82227 US HIGHWAY 111
Address 2: SUITE B-2
City: Indio
State: California
ZIP Code: 92201-5667
Phone: (760) 347-6636

Authorized Official

Name: DR. MARK A GILLISPIE, O.D.
Title: OWNER
Phone: (760) 347-6636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X
Optometrist	152W00000X	Primary

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