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Individual

JACOB DAVID GOZDOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
707 N ALVERNON WAY, TUCSON, AZ 85711-1827
(989) 583-0000
Mailing address
10106 DORCHESTER CT, CLARKSTON, MI 48348-2192
(248) 568-1886

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R80915
AZ
390200000X
Student in an Organized Health Care Education/Training Program
G235356135366
MI

Other

Enumeration date
06/26/2022
Last updated
04/15/2024
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