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Individual

DR. JOHN GENTLESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2301 EVESHAM ROAD, SUITE 207, VOORHEES, NJ 08043-4504
(185) 677-2111
(185) 677-2922
Mailing address
2301 EVESHAM ROAD, SUITE 207, VOORHEES, NJ 08043-4504
(185) 677-2111
(185) 677-2922

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD02135
NJ
213ES0000X
Sports Medicine Podiatrist
MD02135
NJ
213ES0131X
Foot Surgery Podiatrist
MD02135
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000046385
HIGHMARK BLUE SHIELD
NJ
01
01000453900
AMERICHOICE
NJ
01
0321123000
AMERIHEALTH
NJ
05
5245508
NJ
Enumeration date
06/14/2006
Last updated
06/17/2008
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