Individual
JOSEPH D GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 W 12TH ST, PERU, IN 46970-1638
(765) 472-8000
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
01020791A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01020791A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100084220B
—
IN
01
—
220004842
RAILROAD
—
Enumeration date
11/08/2005
Last updated
10/31/2013
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