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General NPI Number Information
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NPI Number | 1518212919
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Entity Type | Individual
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Provider Name | JOSHUA KYLE GARDNER MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2012
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 601-329-9676
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Fax |
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Provider Business Mailing Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 601-329-9676
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 89915
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101254962
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | MD500002936
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License Number State | DC
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