Provider Demographics
NPI:1053525907
Name:GILLESPIE, ROBERT JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:GILLESPIE
Suffix:
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 1:11000 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1714
Mailing Address - Country:US
Mailing Address - Phone:216-844-3234
Mailing Address - Fax:
Practice Address - Street 1:11000 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1714
Practice Address - Country:US
Practice Address - Phone:216-844-3234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096869207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPO1027985OtherRAILROAD MEDICARE
OH0053415Medicaid
9525778OtherAETNA
000000728764OtherUNISON
000000728764OtherANTHEM
OH614125OtherWELLCARE
OH2048816199FEOtherCARESOURCE
OH614125OtherWELLCARE