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Individual

DR. ERIC M GIFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3328 S NATIONAL AVE, SPRINGFIELD, MO 65807-7305
(417) 771-3147
(417) 771-3256
Mailing address
3328 S NATIONAL AVE, SPRINGFIELD, MO 65807-7305
(417) 771-3147
(417) 771-3256

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
2014012495
MO
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
20140124955
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144532490
MO
05
200015259
MO
Enumeration date
07/01/2010
Last updated
08/21/2024
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