Individual
GEMMA BORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2825 E BARNETT RD, MEDFORD, OR 97504-8332
(541) 789-7000
Mailing address
2620 E BARNETT RD, MEDFORD, OR 97504-8383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
197285
OR
207P00000X
Emergency Medicine Physician
60759
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386961415
—
WI
Enumeration date
04/29/2010
Last updated
08/18/2020
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