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NPI Code Detail

MEDICARE: CHRISTOPHER J GAMBLE MD

MEDICARE: CHRISTOPHER J GAMBLE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician83-170492-1205UT

General Provider Information

NPI Number : 1487609277
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER J GAMBLE MD
Provider Business Mailing Address
First Line : 4624 HOLLADAY BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-5206
Country : US
Telephone Number : 801-277-2682
Fax Number : 801-277-2980
Provider Business Practice Location Address
First Line : 4624 HOLLADAY BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-5206
Country : US
Telephone Number : 801-277-2682
Fax Number : 801-277-2980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 06/01/2009

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