| K G Gauntt Dpm Pc | |
|
410 Villa Road, Newberg, OR 97132 | |
| (503) 538-0466 | |
| (503) 538-0913 |
| Full Name | K G Gauntt Dpm Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 410 Villa Road, Newberg, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275770349 | NPI | - | NPPES |
| 001656 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | DP00197 (Oregon) | Primary |
| Provider Name | Kim G Gauntt |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1902908171 PECOS PAC ID: 9335203819 Enrollment ID: I20090128000186 |
| Provider Name | Lacey Beth Lockhart |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1497149454 PECOS PAC ID: 4981997194 Enrollment ID: I20191127002492 |
| Mailing Address | Practice Location Address |
|---|---|
| K G Gauntt Dpm Pc 410 Villa Road, Newberg, OR 97132 Ph: (503) 538-0466 | K G Gauntt Dpm Pc 410 Villa Road, Newberg, OR 97132 Ph: (503) 538-0466 |
Lisa Marie Lipe, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 201 N Washington St, Newberg, OR 97132 Phone: 503-538-0800 | |
Chehalem Valley Foot Clinic, Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 201 N Washington St, Newberg, OR 97132 Phone: 503-538-0800 Fax: 503-554-8408 | |
Mr. Kim Gary Gauntt, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 410 Villa Road, Newberg, OR 97132 Phone: 503-538-0466 Fax: 503-538-0913 |