Provider Demographics
NPI:1518329929
Name:GAYER, CORINN (DO)
Entity Type:Individual
Prefix:
First Name:CORINN
Middle Name:
Last Name:GAYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 E 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2201
Mailing Address - Country:US
Mailing Address - Phone:303-925-4210
Mailing Address - Fax:303-925-4212
Practice Address - Street 1:4075 E 128TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2201
Practice Address - Country:US
Practice Address - Phone:303-925-4210
Practice Address - Fax:303-925-4212
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-43928207Q00000X
COTL.0006004207Q00000X
CODR.0059131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine