Individual
DR. GORDON KENNETH DEAGMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1550 S POTOMAC ST, AURORA, CO 80012-5458
(303) 755-1164
(303) 755-1147
Mailing address
1550 S POTOMAC ST, AURORA, CO 80012-5455
(303) 755-1164
(303) 755-1147
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18107
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01181072
—
CO
Enumeration date
09/14/2005
Last updated
07/08/2007
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