Doctor Name: | DR. GILBERT BAZALDUA |
NPI Number: | 1417011008 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD012487 |
Business Practice Address: | 614b Hwy 76 White House, TN - 37188 |
Business Phone Number: | 6156723767 |
Business Fax Number: | 6156721118 |
Mailing Address: | Po Box 328, WHITE HOUSE |
State: | TN |
Postal Code: | 371880328 |
Phone Number: | 6156723767 |
Fax Number: | 6156721118 |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 01/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD012487 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |