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Individual

KENT E GAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1100 CARSON AVE, LA JUNTA, CO 81050-2751
(719) 384-8181
(719) 384-4872
Mailing address
2201 SAN JUAN AVE, LA JUNTA, CO 81050-3323
(719) 384-8181
(719) 384-4872

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
21632
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01216324
CO
01
DR21632
LICENSE
CO
01
P00341419
RAILROAD MEDICARE
CO
Enumeration date
07/07/2006
Last updated
04/18/2008
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