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1477992592
STANFORD BENJAMIN GAMMON
IDAHO FALLS, ID
NPI
1477992592
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: ID PA-1328)
Enumeration Date
2013-06-21
Last Update Date
2022-07-07
Business Address
STANFORD BENJAMIN GAMMON P.A.
3345 POTOMAC WAY
IDAHO FALLS, ID 83404-4978
Phone number: 208-552-7572
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Mailing Address
STANFORD BENJAMIN GAMMON P.A.
PO BOX 277381
ATLANTA, GA 30384-7381
Phone number:
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