Gaston, Jerry G
Gaston, Jerry G is an individual health care provider with primary practice located at 4013 N Ridge Rd Ste 210, Wichita KS 67205-8860. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gaston, Jerry G can be contacted via phone (316) 945-7309.Contact Information
Primary practice address
4013 N Ridge Rd Ste 210
Wichita KS 67205-8860
Phone: (316) 945-7309
Fax: (316) 945-9131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 05-23472 | Kansas |
Profile Details
| NPI number | 1356340178 |
|---|---|
| LBN Legal business name | Gaston, Jerry G |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Nov 29th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356340178 | NPPES |
| Kansas | MEDICAID | 100189280A |
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