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Individual

DR. KENNETH LEE GOWDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-6661
Mailing address
16666 BIDWELL LN, FONTANA, CA 92336-1454
(316) 641-1497

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2004023916
MO
207L00000X
Anesthesiology Physician
24690
OK
207L00000X
Anesthesiology Physician
Primary
MD-18844
HI
207L00000X
Anesthesiology Physician
MD204530
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025589200
NE
Enumeration date
09/17/2006
Last updated
03/19/2024
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