Organization
GATEWAY DIRECT PRIMARY CARE JV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
(704) 936-5546
Entity
Organization
Contact information
Practice address
1574 WOODLAKE DR, CHESTERFIELD, MO 63017-5712
(866) 808-6005
Mailing address
1400 WEWATTA ST STE 350, DENVER, CO 80202-5553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
07/28/2022
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