Provider Demographics
NPI:1982606919
Name:GILHOOL, WILLIAM J (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:GILHOOL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4148 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-1727
Mailing Address - Country:US
Mailing Address - Phone:215-662-0119
Mailing Address - Fax:215-662-5339
Practice Address - Street 1:4148 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-1727
Practice Address - Country:US
Practice Address - Phone:215-662-0119
Practice Address - Fax:215-662-5339
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002886L207Q00000X, 207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0701759Medicaid
PA0701759Medicaid
PA147448E7PMedicare ID - Type Unspecified