Individual
GARY JAMES TACKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3129
(303) 485-3066
(303) 485-3060
Mailing address
1005 MAR WALT DRIVE, FORT WALTON BEACH, FL 32547-6707
(850) 863-8100
(850) 863-8548
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DR.0067063
CO
207R00000X
Internal Medicine Physician
ME145962
FL
208M00000X
Hospitalist Physician
Primary
DR.0067063
CO
Other
Enumeration date
04/19/2017
Last updated
01/29/2024
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