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Individual

DR. LAURENCE F GAYNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
(303) 761-9190
Mailing address
10700 E GEDDES AVE, NO 200, ENGLEWOOD, CO 80112-3800
(303) 761-9190
(303) 761-6278

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18133
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01181338
CO
01
02555484
NY MEDICAID
NY
01
053216001
TX MEDICAID
TX
05
100017792
WI
05
100257090000
NE
01
104686150
MI MEDICAID
MI
05
1336126184
IL
05
1336126184
UT
05
1336126184
WY
05
179782001
AR
05
200410090A
KS
05
200424900A
OK
05
2316265
LA
01
300049135
RR MCRE RIA
CO
01
300089928
RR MCRE MIC
CO
01
414545970A
GA MEDICAID
GA
05
7100227240
KY
05
7617666
NC
05
84-059792913
NE
05
84073331
NM
01
922121
AZ MEDICAID
AZ
01
XPY201227
CA MEDICAID
CA
Enumeration date
12/22/2005
Last updated
07/07/2014
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