Healthcare Provider Details

I. General information

NPI: 1669585790
Provider Name (Legal Business Name): GAYATHRI J SEKHARAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 N 11TH ST
GRAND JUNCTION CO
81501-8102
US

IV. Provider business mailing address

2440 N 11TH ST
GRAND JUNCTION CO
81501-8102
US

V. Phone/Fax

Practice location:
  • Phone: 970-625-1100
  • Fax:
Mailing address:
  • Phone: 970-625-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number42059
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: