Individual
ASHLEY C GULLIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
0102208051
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2020
Last updated
07/22/2024
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