Provider Demographics
NPI:1487761250
Name:GILL, THOMAS HAYDEN II (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HAYDEN
Last Name:GILL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2606
Mailing Address - Country:US
Mailing Address - Phone:816-881-6610
Mailing Address - Fax:816-404-1345
Practice Address - Street 1:660 E 24TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2606
Practice Address - Country:US
Practice Address - Phone:816-881-6610
Practice Address - Fax:816-404-1345
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003001213173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine