Healthcare Provider Details

I. General information

NPI: 1518039296
Provider Name (Legal Business Name): GEORGE F GWINN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34597 N 60TH ST SUITE 100
SCOTTSDALE AZ
85266-5240
US

IV. Provider business mailing address

34597 N 60TH ST SUITE 100
SCOTTSDALE AZ
85266-5240
US

V. Phone/Fax

Practice location:
  • Phone: 480-473-7800
  • Fax: 480-513-8704
Mailing address:
  • Phone: 480-473-7800
  • Fax: 480-513-8704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25811
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: