Provider Demographics
NPI:1730936816
Name:GILL, WILLIAM DONALD II (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DONALD
Last Name:GILL
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:939 LAKE HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:DEATSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36022-4402
Mailing Address - Country:US
Mailing Address - Phone:251-689-4638
Mailing Address - Fax:
Practice Address - Street 1:939 LAKE HAVEN DR
Practice Address - Street 2:
Practice Address - City:DEATSVILLE
Practice Address - State:AL
Practice Address - Zip Code:36022-4402
Practice Address - Country:US
Practice Address - Phone:251-209-2043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist