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NPI Code Detail

MEDICARE: DELLA GASKIN

MEDICARE:   DELLA  GASKIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOpticianKY

General Provider Information

NPI Number : 1710616131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELLA GASKIN
Provider Business Mailing Address
First Line : 150 WALTON AVE
Second Line :
City : BOWLING GREEN
State : KY
Zip : 42104-6361
Country : US
Telephone Number : 270-781-5194
Fax Number : 270-781-5763
Provider Business Practice Location Address
First Line : 150 WALTON AVE
Second Line :
City : BOWLING GREEN
State : KY
Zip : 42104-6361
Country : US
Telephone Number : 270-781-5194
Fax Number : 270-781-5763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2022
Last Update Date : 06/09/2022

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Directions to “ DELLA GASKIN ” Practice Location

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