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Individual

GORDON JULIAN SHUMATE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
405 SOUTH ST STE F, REDDING, CA 96001-2101
(530) 246-4800
(530) 246-4802
Mailing address
405 SOUTH ST STE F, REDDING, CA 96001-2101
(530) 246-4800
(530) 246-4802

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E3936
CA
213ES0000X
Sports Medicine Podiatrist
E3936
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E39360
CA
Enumeration date
07/19/2006
Last updated
06/27/2008
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