Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | POD001064 | GA |
Y | 213ES0131X | Foot Surgery | 298 | AL |
NPI | 1295907087 |
---|---|
Provider Name | Dr. Brooke Leann Gorham |
First Address | Gadsden, AL 35901-5213 |
Second Address | Gadsden, AL 35901-5213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 02/03/2011 |