STANFORD BENJAMIN GAMMON

IDAHO FALLS, ID
NPI1477992592
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: ID  PA-1328)
Enumeration Date2013-06-21
Last Update Date2022-07-07
Business Address
STANFORD BENJAMIN GAMMON P.A.
3345 POTOMAC WAY
IDAHO FALLS, ID 83404-4978
Phone number: 208-552-7572
Mailing Address
STANFORD BENJAMIN GAMMON P.A.
PO BOX 277381
ATLANTA, GA 30384-7381
Phone number:
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