Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gannon Frederick Gill, PA

Individual provider Physician Assistant · NPI 1972808327

Gannon Frederick Gill, PA is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2010, 16 years ago. Practices with St John Physicians, Inc, a 264-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
16
Licensed in
OK
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

6475 S Yale Ave Ste 200
Tulsa, OK 74136-7816
Phone: (918) 494-4460
Fax: (918) 502-3468
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1950 (OK)

Record details

NPI number1972808327
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 17, 2011
Last updated in NPPESOctober 3, 2023
Certification dateOctober 3, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice St. John Physicians, Inc. — 264 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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