Provider Demographics
NPI:1376685222
Name:GERSHON, JULIAN ROBERT JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:ROBERT
Last Name:GERSHON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:321 ROOD AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2451
Mailing Address - Country:US
Mailing Address - Phone:970-243-8524
Mailing Address - Fax:970-263-4334
Practice Address - Street 1:321 ROOD AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2451
Practice Address - Country:US
Practice Address - Phone:970-243-8524
Practice Address - Fax:970-263-4334
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG9462207QS0010X
CO48487207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine