Individual
IKE B GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM.,PC
Contact information
Practice address
1500 N WILMOT RD, STE A230, TUCSON, AZ 85712-4416
(520) 722-5115
(520) 722-0611
Mailing address
PO BOX 69040, TUCSON, AZ 85737
(520) 722-5115
(520) 722-0611
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
301
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700981
—
AZ
Enumeration date
03/27/2006
Last updated
05/17/2011
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