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Individual

DR. CORY L GAMBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
6801 ROGERS AVE, FORT SMITH, AR 72903-4067
(479) 452-2077
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 452-2077

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
C-6494
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110033455
RR MEDICARE
05
114011003
AR
Enumeration date
07/18/2006
Last updated
09/13/2007
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