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Individual

DR. GAYLE ANN HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2111 COLLEGE DR, GALLUP, NM 87301-5600
(505) 863-1820
(505) 863-1898
Mailing address
6440 SOUTH MILLROCK DRIVE, SUITE 175, SALT LAKE CITY, UT 84121

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
7590
SD
208000000X
Pediatrics Physician
81831
WY
208000000X
Pediatrics Physician
A60050
CA
208000000X
Pediatrics Physician
MD00035594
WA
208000000X
Pediatrics Physician
Primary
MD19928
OR
208000000X
Pediatrics Physician
MD20090692
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150718
OR
01
858597000
BLUE CROSS
OR
01
9305053253002
EMPLOYER ID
OR
Enumeration date
06/30/2006
Last updated
03/22/2010
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