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Individual

JOHN M GOSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1256
Mailing address
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1256

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01021484A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77025555
NM
05
809999
AZ
Enumeration date
07/05/2006
Last updated
04/11/2008
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