Individual
JACOB GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10 DUKE MEDICINE CIR, DURHAM, NC 27710-1000
(919) 684-8111
Mailing address
3501 ANTIOCH CHURCH RD, MATTHEWS, NC 28104-5499
(704) 541-8366
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/17/2021
Last updated
06/28/2021
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