person
Stanford Benjamin Gammon, PA
Surgical Physician Assistant in Idaho Falls, Idaho
NPI 1477992592

Stanford Benjamin Gammon is a Surgical Physician Assistant based in Atlanta, ID and is specialized in Surgical. Stanford Benjamin Gammon practices in Idaho Falls, ID and has the professional credentials of PA. The NPI Number for Stanford Benjamin Gammon is 1477992592 and holds a License No. PA-1328 (Idaho).

The current practice location address for Stanford Benjamin Gammon is 3345 Potomac Way, Idaho Falls, ID and can be reached out via phone at 208-552-7572 and via fax at 208-552-7312.

Location: 3345 Potomac Way, Idaho Falls, ID, 30384-7381
person
Provider Profile Details
NPI Number
1477992592
Provider Name
Stanford Benjamin Gammon
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
3345 Potomac Way, Idaho Falls, ID, 30384-7381
Phone Number
208-552-7572
Fax Number
208-552-7312
Provider Enumeration Date
06/21/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3345 Potomac Way
City
State
Zip
83404-4978
Phone Number
208-552-7572
Fax Number
208-552-7312
person
Provider Business Mailing Address Details
Address
3345 Potomac Way
City
State
Zip
83404-4978
Phone Number
208-552-7572
Fax Number
208-552-7312
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA-1328 (Idaho)
Definition
Definition to come...
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