Individual
DR. MARK D GAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
523B SOUTH CAMINO DEL RIO, DURANGO, CO 81303-6853
(970) 247-2970
(970) 259-1668
Mailing address
523 S CAMINO DEL RIO STE B, DURANGO, CO 81303-6853
(970) 247-1970
(970) 259-1668
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
37711
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06977529
—
CO
Enumeration date
08/02/2006
Last updated
07/30/2013
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