Individual
DR. PHILIP A GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 JUDGE TANNER BLVD STE 300, COVINGTON, LA 70433-7506
(985) 867-2128
(985) 871-1548
Mailing address
101 JUDGE TANNER BLVD STE 300, COVINGTON, LA 70433-7506
(985) 867-2128
(985) 871-1548
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
03988R
LA
2086S0129X
Vascular Surgery Physician
Primary
03988R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1319210
—
LA
Enumeration date
02/13/2006
Last updated
02/13/2023
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