Gardner, Jed R.

Gardner, Jed R. is an individual health care provider with primary practice located at 3801 Scott And White Dr , Killeen TX 76543-5252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gardner, Jed R. can be contacted via phone (254) 680-1100.

Contact Information

Primary practice address
3801 Scott And White Dr Killeen TX 76543-5252
Phone: (254) 680-1100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K2472 Texas

Profile Details

NPI number 1861452542
LBN Legal business name Gardner, Jed R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Jul 11th, 2007 - about 17 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 1861452542 NPPES
Texas MEDICAID 1050965-02
Texas Other 86771K
Texas Other 080162295

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