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General NPI Number Information
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NPI Number | 1619023652
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Entity Type | Organization
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Legal Business Name | WILLIAM T GAUNT PLLC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 255 CHURCH ST SUITE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-3476
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Country | US
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Telephone | 606-218-6101
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Fax |
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Provider Business Mailing Address
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Address Line | 255 CHURCH ST SUITE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-3476
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Country | US
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Telephone | 606-218-6101
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM T GAUNT
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Credential | M.D.
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Telephone | 606-218-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 36341
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License Number State | KY
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