Individual
DR. KENNETH RAY GAMBLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
963 E COLORADO AVE, COLORADO SPRINGS, CO 80903-3776
(719) 578-1119
(719) 578-1487
Mailing address
963 E COLORADO AVE, COLORADO SPRINGS, CO 80903-3776
(719) 578-1119
(719) 578-1487
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
17345
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01173459
—
CO
Enumeration date
06/21/2005
Last updated
08/05/2009
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