Jacob David Gozdor
Jacob David Gozdor is a Student in an Organized Health Care Education/Training Program in Tucson, Arizona. Licensed in Arizona and Michigan. Registered with an NPI since 2022.
- Licensed in
- AZ, MI
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
707 N Alvernon WayTucson, AZ 85711-1827
Phone: (989) 583-0000
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Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence R80915 (AZ) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X · Licence G235356135366 (MI) |
Record details
| NPI number | 1407588817 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 26, 2022 |
| Last updated in NPPES | April 15, 2024 |
| Certification date | April 15, 2024 |
| Mailing address | 10106 Dorchester Ct, Clarkston, MI 48348-2192 |
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