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Contact Information

KIM G GAUNTT, DPM
410 VILLA ROAD
NEWBERG, OR97132-1904
 Phone: 503-538-0466
 Fax: 503-538-0913
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for KIM G GAUNTT · (Male)

NPI # 1902908171
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 09/01/2006
Last updated 01/16/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # DP00197
  • OR Medicaid 001656
Hospital affiliation(s)
  • PROVIDENCE NEWBERG MEDICAL CENTER - (Acute Care)
    1001 PROVIDENCE DRIVE
    NEWBERG, OR 97132
  • TUALITY COMMUNITY HOSPITAL - (Acute Care)
    335 SE 8TH AVENUE
    HILLSBORO, OR 97123
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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