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Individual

GARY LEE WADDINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
14239 W BELL RD, SUITE 101, SURPRISE, AZ 85374-2469
(623) 544-7755
(623) 544-8665
Mailing address
14239 W BELL RD, SUITE 101, SURPRISE, AZ 85374-2469
(623) 544-7755
(623) 544-8665

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
12916
AZ
207KA0200X
Allergy Physician
12916
AZ
207N00000X
Dermatology Physician
Primary
12916
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
12916
AZ
207ND0900X
Dermatopathology Physician
12916
AZ
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
12916
AZ
207NP0225X
Pediatric Dermatology Physician
12916
AZ
207NS0135X
Procedural Dermatology Physician
12916
AZ

Other

Enumeration date
09/09/2005
Last updated
05/15/2013
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