Gardner, Geraldine

Gardner, Geraldine is an individual health care provider with primary practice located at 900 Sunset Dr , La Grande OR 97850-1387. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Gardner, Geraldine can be contacted via phone (541) 963-2328.

Contact Information

Primary practice address
900 Sunset Dr La Grande OR 97850-1387
Fax: (541) 975-5210
Website:

Profile Details

NPI number 1033101696
LBN Legal business name Gardner, Geraldine
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Aug 13th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033101696 NPPES
Wyoming MEDICAID 123264900
Wyoming MEDICAID 500769777
Wyoming MEDICAID 2016356

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