Provider Demographics
NPI:1861533390
Name:GILLESPIE, MARGARET WALKER (OD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:WALKER
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:F
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:10811 MOORS END CIR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2612
Mailing Address - Country:US
Mailing Address - Phone:317-595-2127
Mailing Address - Fax:
Practice Address - Street 1:10209 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7985
Practice Address - Country:US
Practice Address - Phone:317-271-6824
Practice Address - Fax:317-271-8089
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ18002582152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU57918Medicare UPIN