Provider Demographics
NPI:1588634588
Name:GECKLE, DAVID S (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:GECKLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1651 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4605
Mailing Address - Country:US
Mailing Address - Phone:804-288-8248
Mailing Address - Fax:804-282-6223
Practice Address - Street 1:10710 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE 138
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4722
Practice Address - Country:US
Practice Address - Phone:804-330-4990
Practice Address - Fax:804-330-4529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055621207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG17289Medicare UPIN