Provider Demographics
NPI:1689697724
Name:GILL, NAVDEEP (OD)
Entity type:Individual
Prefix:DR
First Name:NAVDEEP
Middle Name:
Last Name:GILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 E HIGHLAND AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4794
Mailing Address - Country:US
Mailing Address - Phone:480-994-5012
Mailing Address - Fax:602-942-2667
Practice Address - Street 1:5620 W THUNDERBIRD RD STE B1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4638
Practice Address - Country:US
Practice Address - Phone:480-994-5012
Practice Address - Fax:480-994-9479
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4533152W00000X
AZ1663152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW16459OtherBCBS OF MA
AZ537175Medicaid
MAW16459OtherBCBS OF MA
MAW17634Medicare ID - Type Unspecified