Provider Demographics
NPI:1578668323
Name:GATHRIGHT, DAVID JESSE SR (MHS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JESSE
Last Name:GATHRIGHT
Suffix:SR
Gender:M
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PHILADELPHIA VA MEDICAL CENTER
Mailing Address - Street 2:3900 WOODLAND AVE.
Mailing Address - City:PHILADELPHIA,
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-823-5809
Mailing Address - Fax:
Practice Address - Street 1:PHILADELPHIA VA MEDICAL CENTER
Practice Address - Street 2:3900 WOODLAND AVE.
Practice Address - City:PHILADELPHIA,
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-823-5809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)