Individual
DR. RONALD D GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
25647 REDWOOD HWY, CAVE JUNCTION, OR 97531-9724
(541) 592-4111
(541) 592-3916
Mailing address
PO BOX 158, GRANTS PASS, OR 97528-0012
(541) 592-4111
(541) 592-3916
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1372
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127725
—
OR
Enumeration date
11/17/2006
Last updated
05/14/2008
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