Individual
DR. GARY ROSCOE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
13106 SHELBYVILLE RD, LOUISVILLE, KY 40243-1572
(502) 253-0025
(502) 253-9933
Mailing address
5213 WINDY WILLOW DR, LOUISVILLE, KY 40241-1360
(502) 241-6730
(502) 253-9933
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4707
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000347132
BCBS PROVIDER NUMBER
KY
01
—
3428389
CIGNA PROVIDER NUMBER
KY
05
—
50005767
—
KY
01
—
650593
UNITED HEALTH CARE NUMBER
KY
01
—
7135162
AETNA PROVIDER NUMBER
KY
Enumeration date
07/31/2006
Last updated
07/09/2007
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