Individual
DR. GENE A BOURGASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 N 1000 W, LINTON, IN 47441-5013
(812) 847-4481
Mailing address
1185 N 1000 W, LINTON, IN 47441-5282
(812) 847-4481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030642
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210220B
—
IN
05
—
200015680A
—
IN
Enumeration date
05/23/2005
Last updated
09/17/2019
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