Individual
GAVIN ARTHUR GORRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2947 RODEO PARK DR E, SANTA FE, NM 87505-6303
(505) 983-6613
(505) 986-9984
Mailing address
8801 HORIZON BLVD NE STE 360, ALBUQUERQUE, NM 87113-1563
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD2022-0431
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2G1824
MEDICARE PTAN
NM
05
—
35670029
—
NM
Enumeration date
07/11/2018
Last updated
10/22/2024
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