Individual
JERRY LEE GAUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102208063
VA
Other
Enumeration date
04/15/2022
Last updated
07/04/2025
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