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NPI Code Detail

MEDICARE: JOSHUA GORE MD

MEDICARE:   JOSHUA  GORE  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
1207L00000XAnesthesiology Physician37602SC
2207L00000XAnesthesiology Physician27876OK

General Provider Information

NPI Number : 1891015061
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA GORE MD
Provider Business Mailing Address
First Line : 4131 NW 122ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-8869
Country : US
Telephone Number : 405-775-9350
Fax Number :
Provider Business Practice Location Address
First Line : 1621 HIGHWAY 17 N
Second Line :
City : NORTH MYRTLE BEACH
State : SC
Zip : 29582-2229
Country : US
Telephone Number : 843-353-3460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2010
Last Update Date : 07/22/2022

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Directions to “ JOSHUA GORE MD” Practice Location

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