Individual
DR. GAVIN SMILEY GULLICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-5189
(315) 464-7494
Mailing address
224 HARRISON ST STE 601, SYRACUSE, NY 13202-3186
(315) 464-5660
(315) 464-7695
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
337231
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2020
Last updated
06/17/2025
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