Provider Demographics
NPI:1811989114
Name:GEBHARD, JAMES S (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:GEBHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:627 25 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-6401
Mailing Address - Country:US
Mailing Address - Phone:970-242-3535
Mailing Address - Fax:970-623-8599
Practice Address - Street 1:627 25 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-6401
Practice Address - Country:US
Practice Address - Phone:970-242-3535
Practice Address - Fax:970-623-8599
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31596207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO200039770OtherRAILROAD MEDICARE
CO01315969Medicaid
COF51054Medicare UPIN
CON8078Medicare ID - Type Unspecified