Individual
DAMON L GATEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
58 CITATION LANE, CAMPBELLSBURG, KY 40011-1426
(502) 532-7341
(502) 532-0127
Mailing address
58 CITATION LANE, CAMPBELLSBURG, KY 40011-0460
(502) 532-7341
(502) 532-0127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37028
KY
207R00000X
Internal Medicine Physician
Primary
37028
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225634
ANTHEM
KY
01
—
1165569
PASSPORT
KY
01
—
2439968000
PASSPORT ADVANTAGE
KY
05
—
64051949
—
KY
Enumeration date
03/07/2006
Last updated
08/18/2017
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