Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 10814 | MT |
Y | 207X00000X | Orthopaedic Surgeon | 16044 | SC |
N | 207X00000X | Orthopaedic Surgeon | 24746 | OK |
N | 207X00000X | Orthopaedic Surgeon | 35902 | NC |
N | 207X00000X | Orthopaedic Surgeon | 52397 | CA |
N | 207X00000X | Orthopaedic Surgeon | MD009475 | TN |
N | 207X00000X | Orthopaedic Surgeon | MD05635R | LA |
N | 207X00000X | Orthopaedic Surgeon | MD2005-0607 | NM |
N | 207X00000X | Orthopaedic Surgeon | MD26366 | OR |
NPI | 1003924879 |
---|---|
Provider Name | Richard Dennis Gardner |
First Address | Hilton Head Island, SC 29928-3575 |
Second Address | Hilton Head Island, SC 29928-3575 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |