Provider Demographics
NPI:1134268162
Name:GAZIC, JOSIP (MD)
Entity type:Individual
Prefix:
First Name:JOSIP
Middle Name:
Last Name:GAZIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:7850 JEFFERSON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4315
Mailing Address - Country:US
Mailing Address - Phone:505-884-1114
Mailing Address - Fax:505-856-6320
Practice Address - Street 1:7850 JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4315
Practice Address - Country:US
Practice Address - Phone:505-884-1114
Practice Address - Fax:505-856-6320
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM2002-502084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry