Healthcare Provider Details

I. General information

NPI: 1326281239
Provider Name (Legal Business Name): JOHN DENNIS GULL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1784 BROWNING WAY STE 120
ELKO NV
89801-8331
US

IV. Provider business mailing address

1784 BROWNING WAY STE 120
ELKO NV
89801-8331
US

V. Phone/Fax

Practice location:
  • Phone: 775-738-2555
  • Fax: 775-738-2585
Mailing address:
  • Phone: 775-738-2555
  • Fax: 775-738-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDO1475
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberDO1475
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: