Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 228 | MN |
Y | 213ES0103X | Foot & Ankle Surgery | PD-000951 | AZ |
N | 213ES0131X | Foot Surgery | SC006979 | PA |
NPI | 1194101949 |
---|---|
Provider Name | Catlea Gorman |
First Address | Flagstaff, AZ 86001-1483 |
Second Address | Flagstaff, AZ 86001-1483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2015 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002810 | (05) | AZ |