Provider Demographics
NPI:1962662858
Name:GILLEY, PAMELA GAIL (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:GAIL
Last Name:GILLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:GAIL
Other - Last Name:DEHMLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 DOVER ST STE 207
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2824
Mailing Address - Country:US
Mailing Address - Phone:931-685-4060
Mailing Address - Fax:931-685-4062
Practice Address - Street 1:200 DOVER ST STE 207
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2824
Practice Address - Country:US
Practice Address - Phone:931-685-4060
Practice Address - Fax:931-685-4062
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000017973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine