K G Gauntt Dpm Pc | |
410 Villa Road, Newberg, OR 97132 | |
(503) 538-0466 | |
(503) 538-0913 |
Full Name | K G Gauntt Dpm Pc |
---|---|
Type | Facility |
Speciality | Podiatrist |
Location | 410 Villa Road, Newberg, Oregon |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275770349 | NPI | - | NPPES |
001656 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | DP00197 (Oregon) | Primary |
Provider Name | Kim G Gauntt |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1902908171 PECOS PAC ID: 9335203819 Enrollment ID: I20090128000186 |
Provider Name | Lacey Beth Lockhart |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1497149454 PECOS PAC ID: 4981997194 Enrollment ID: I20191127002492 |
Mailing Address | Practice Location Address |
---|---|
K G Gauntt Dpm Pc 410 Villa Road, Newberg, OR 97132 Ph: (503) 538-0466 | K G Gauntt Dpm Pc 410 Villa Road, Newberg, OR 97132 Ph: (503) 538-0466 |
Lisa Marie Lipe, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 201 N Washington St, Newberg, OR 97132 Phone: 503-538-0800 | |
Chehalem Valley Foot Clinic, Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 201 N Washington St, Newberg, OR 97132 Phone: 503-538-0800 Fax: 503-554-8408 | |
Mr. Kim Gary Gauntt, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 410 Villa Road, Newberg, OR 97132 Phone: 503-538-0466 Fax: 503-538-0913 |