Individual
WILLIAM SHAUN GOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
(719) 269-9386
Mailing address
6 SWIFT ARROW CT, PUEBLO, CO 81001-1800
(719) 250-5326
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34360
CO
207Q00000X
Family Medicine Physician
Primary
34360
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01343607
—
CO
Enumeration date
11/25/2005
Last updated
11/29/2022
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