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General NPI Number Information
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NPI Number | 1114169778
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Entity Type | Individual
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Provider Name | JULIA RENEE GASTON M.D,
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Gender | Female
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Dates
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Enumeration Date | 03/29/2009
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1110 SAINT MARYS RD
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City | JUNCTION CITY
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State | KS
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Zip | 66441-4176
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Country | US
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Telephone | 785-762-2585
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Fax | 785-238-5450
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Provider Business Mailing Address
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Address Line | 13517 GREEN CEDAR LN
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City | OKLAHOMA CITY
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State | OK
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Zip | 73131-1837
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Country | US
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Telephone | 316-841-0081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 55126-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 04-50714
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License Number State | KS
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