Organization
IKE B. GORMAN DPM., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IKE B GORMAN DPM (OWNER)
(520) 722-5115
Entity
Organization
Contact information
Practice address
1500 N WILMOT RD, SUITE A230, TUCSON, AZ 85712-4416
(520) 722-5115
(520) 722-0611
Mailing address
PO BOX 69040, TUCSON, AZ 85737-0009
(520) 722-5115
(520) 722-0611
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
301
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700981
—
AZ
Enumeration date
02/28/2008
Last updated
05/17/2011
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