K G Gauntt Dpm PC

NPI #1275770349 in Newberg, Oregon

Provider Information

NPI Number: 1275770349
Entity Type: Organization
Organization Name: K G Gauntt Dpm PC
Primary Specialty: Podiatrist
Enumeration Date: Jan 12, 2009
Last Updated: Jan 12, 2009

Practice Location

Address: 410 VILLA ROAD
City: Newberg
State: Oregon
ZIP Code: 97132
Phone: (503) 538-0466

Authorized Official

Name: DR. KIM GARY GAUNTT, DPM
Title: PRESIDENT
Phone: (503) 538-0466

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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