Individual
LAURA EASTBURN KECK GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101261499
VA
207N00000X
Dermatology Physician
ME121790
FL
207R00000X
Internal Medicine Physician
151494
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014109700
—
FL
Enumeration date
05/13/2010
Last updated
06/01/2021
Update your record
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