Individual
DR. GARTH GRANT GULICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 S 3RD ST, NYSSA, OR 97913-3815
(208) 642-9376
(208) 642-9279
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-9376
(208) 642-9279
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M8925
ID
207Q00000X
Family Medicine Physician
Primary
MD18963
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
O65552
—
OR
Enumeration date
05/31/2007
Last updated
01/14/2026
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