Dr. Henry Jerry Gardner, M.D.
Family Medicine in The Villages, FL. Individual provider (NPI-1).
NPI number1609899293
StatusActive
Last updated in NPPESJun 14, 2011
Details
- NPI
- 1609899293
- Entity type
- Individual (NPI-1)
- Name
- Dr. Henry Jerry Gardner
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 25, 2006
- Last updated
- Jun 14, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 1504831205 | UT | Yes |
Other names
- H Jerry Gardner (Professional Name)
Practice location
8900 Se 165th Mulberry LnThe Villages, FL 32162-5884
Phone 352-674-5000 · Fax 352-674-5031
Mailing address
11248 N Park DrHighland, UT 84003-9611
Phone 801-369-7367
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