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General NPI Number Information
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NPI Number | 1386776722
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Entity Type | Organization
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Legal Business Name | SUSAN C GASKILL MD PA
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2211 WEST FM 646 100
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City | DICKINSON
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State | TX
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Zip | 77539
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Country | US
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Telephone | 877-868-4286
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25943
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City | OKLAHOMA CITY
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State | OK
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Zip | 73125-0943
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Country | US
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Telephone | 877-868-4286
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN C GASKILL
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Credential | MD
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Telephone | 877-868-4286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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