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General NPI Number Information
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NPI Number | 1336114800
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Entity Type | Individual
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Provider Name | RACHELLE L GORRELL D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 1000 N JEFFERSON ST
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City | SAINT JAMES
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State | MO
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Zip | 65559
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Country | US
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Telephone | 573-265-8840
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Fax | 573-202-2474
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Provider Business Mailing Address
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Address Line | 1050 W 10TH ST
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City | ROLLA
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State | MO
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Zip | 65401-2905
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Country | US
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Telephone | 573-364-9000
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2001007763
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License Number State | MO
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