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

Scott R Gillum, PA

Individual provider Surgical Physician Assistant · NPI 1114003076

Scott R Gillum, PA is a Physician Assistant in Shreveport, Louisiana. Qualified in 2006, 20 years ago. Practices with Wk Orthopedic Clinic, a 21-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
20
Licensed in
LA
In the registry since
2006
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

7925 Youree Dr Ste 200
Shreveport, LA 71105-5127
Phone: (318) 212-3610
Fax: (318) 212-3672
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA200106 (LA)

Record details

NPI number1114003076
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 31, 2006
Last updated in NPPESJuly 14, 2021
Certification dateJuly 14, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Wk Orthopedic Clinic — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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