Wofford, Gary Gene
Wofford, Gary Gene is an sole proprietor health care provider with primary practice located at 1600 N Grand Ave #230, Pueblo CO 81003-2700. He recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as his primary health care specialty. Wofford, Gary Gene can be contacted via phone (719) 562-1000.Contact Information
Primary practice address
1600 N Grand Ave #230
Pueblo CO 81003-2700
Phone: (719) 562-1000
Fax: (719) 562-1827
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Managed Care Organizations / Exclusive Provider Organization | 302F00000X | 30398 | Colorado |
Profile Details
| NPI number | 1063500544 |
|---|---|
| LBN Legal business name | Wofford, Gary Gene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1063500544 | NPPES |
| Colorado | MEDICAID | 0130398 |
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