Provider Demographics
NPI:1063445567
Name:PRICE, GARY MITCHELL (MD, FACP)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:MITCHELL
Last Name:PRICE
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 COMMERCE CENTER CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3607
Mailing Address - Country:US
Mailing Address - Phone:239-415-1111
Mailing Address - Fax:239-415-1199
Practice Address - Street 1:9722 COMMERCE CENTER CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3607
Practice Address - Country:US
Practice Address - Phone:239-415-1111
Practice Address - Fax:239-415-1199
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0042759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine