Individual
DR. GOWAN JESSEN DECKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2359 S 22ND DR, STE 2, YUMA, AZ 85364
(928) 344-4800
(928) 726-2377
Mailing address
2400 S AVENUE A STE 2, YUMA, AZ 85364-7127
(928) 344-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20484
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139768
—
AZ
01
—
AZ0340800
BCBS
AZ
Enumeration date
12/13/2006
Last updated
11/18/2024
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