Mr Larry Wayne Gardner, MD in Colville, WA - Dermatology

Mr Larry Wayne Gardner, MD is a Dermatology physician based in Colville, Washington. Mr Larry Wayne Gardner is licensed to practice in Nevada (license number 3301) and his current practice location is 143 Garden Homes Dr, Colville, Washington. He can be reached at his office (for appointments etc.) via phone at (509) 684-3701.

NPI number for Mr Larry Wayne Gardner is 1114095437 and his current mailing address is 1200 E Columbia Ave, Colville, Washington. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114095437.

Contact Information

	Mr Larry Wayne Gardner, MD
	143 Garden Homes Dr, Colville, WA 99114-9229
	(509) 684-3701
	(509) 684-5817

Physician's Profile

Full Name	Mr Larry Wayne Gardner
Gender	Male
Speciality	Dermatology
Location	143 Garden Homes Dr, Colville, Washington
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1114095437
Provider Enumeration Date: 12/04/2006
Last Update Date: 04/23/2010

Medical Identifiers

Medical identifiers for Mr Larry Wayne Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114095437	NPI	-	NPPES
002016241	Medicaid	NV

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	3301 (Nevada)	Primary
207ND0900X	Dermatology - Dermatopathology	3301 (Nevada)	Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Larry Wayne Gardner is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Larry Wayne Gardner, MD 1200 E Columbia Ave, Colville, WA 99114-3354 Ph: (509) 684-3701	Mr Larry Wayne Gardner, MD 143 Garden Homes Dr, Colville, WA 99114-9229 Ph: (509) 684-3701

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Mr Larry Wayne Gardner, MD - Dermatology in Colville, WA