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Mr. Gavin Blair Gore
Diagnostic Radiology Physician in Leesburg, Virginia
NPI 1316189608

Gavin Blair Gore is a Diagnostic Radiology Physician based in Leesburg, VA and is specialized in Diagnostic Radiology. Gavin Blair Gore practices in Leesburg, VA. The NPI Number for Gavin Blair Gore is 1316189608 and holds a License No. 2013-02510 (Virginia).

The current practice location address for Gavin Blair Gore is 19500 Sandridge Way, Suite 420, Leesburg, VA and can be reached out via phone at 571-375-8601 and via fax at 571-223-6773.

Location: 19500 Sandridge Way, Suite 420, Leesburg, VA, 20176-2704
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316189608
Provider Name
Gavin Blair Gore
Credential
Provider Entity Type
Individual
Gender
Male
Address
19500 Sandridge Way, Suite 420, Leesburg, VA, 20176-2704
Phone Number
571-375-8601
Fax Number
571-223-6773
Provider Enumeration Date
04/01/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1316189608 05 VA
institution
Provider Business Practice Location Address Details
Address
19500 Sandridge Way, Suite 420
City
Leesburg
State
Virginia
Zip
20176-3467
Phone Number
571-375-8601
Fax Number
571-223-6773
person
Provider Business Mailing Address Details
Address
19500 Sandridge Way, Suite 420
City
Leesburg
State
Virginia
Zip
20176-3467
Phone Number
571-375-8601
Fax Number
571-223-6773
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
()
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
2013-02510 (North Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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