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
Fax: (719) 562-1827
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063500544 NPPES
Colorado MEDICAID 0130398

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