DR. Russell Moss Gilliam, OD

NPI #1689775520 in Union City, Tennessee

Provider Information

NPI Number: 1689775520
Entity Type: Individual
Name: DR. Russell Moss Gilliam, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Sep 25, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1022 S MILES AVE
City: Union City
State: Tennessee
ZIP Code: 38261-5432
Phone: (731) 885-1049

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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