Individual
SHAWNA C GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
(573) 426-3643
Mailing address
1050 W 10TH ST, ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINCS, ROLLA, MO 65401-2905
(573) 364-9000
(573) 426-2108
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2014008977
MO
Other
Enumeration date
07/13/2011
Last updated
08/22/2019
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