Mr Larry Wayne Gardner, MD is a
Dermatology physician based in Colville, Washington. Mr Larry Wayne Gardner is licensed to practice in Nevada (license number 3301) and his current practice location is 143 Garden Homes Dr, Colville, Washington. He can be reached at his office (for appointments etc.) via phone at
(509) 684-3701.
NPI number for Mr Larry Wayne Gardner is 1114095437 and his current mailing address is 1200 E Columbia Ave, Colville, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114095437.
Physician's Profile
Full Name | Mr Larry Wayne Gardner |
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Gender | Male |
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Speciality | Dermatology |
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Location | 143 Garden Homes Dr, Colville, Washington |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1114095437
- Provider Enumeration Date: 12/04/2006
- Last Update Date: 10/27/2024
Medical Identifiers
Medical identifiers for Mr Larry Wayne Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1114095437 | NPI | - | NPPES |
002016241 | Medicaid | NV | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | 3301 (Nevada) | Primary |
207ND0900X | Dermatology - Dermatopathology | 3301 (Nevada) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Larry Wayne Gardner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Larry Wayne Gardner, MD 1200 E Columbia Ave, Colville, WA 99114-3354 Ph: (509) 684-3701 | Mr Larry Wayne Gardner, MD 143 Garden Homes Dr, Colville, WA 99114-9229 Ph: (509) 684-3701 |
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