Gamblin, Kenneth Ray
Gamblin, Kenneth Ray is an sole proprietor health care provider with primary practice located at 963 E Colorado Ave , Colorado Springs CO 80903-3776. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Gamblin, Kenneth Ray can be contacted via phone (719) 578-1119.Contact Information
Primary practice address
963 E Colorado Ave
Colorado Springs CO 80903-3776
Phone: (719) 578-1119
Fax: (719) 578-1487
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 17345 | Colorado |
Profile Details
| NPI number | 1063418408 |
|---|---|
| LBN Legal business name | Gamblin, Kenneth Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Aug 5th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063418408 | NPPES |
| Colorado | MEDICAID | 01173459 |
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