Provider Demographics
NPI:1548881824
Name:GARDNER, BRET JARRET (MD)
Entity type:Individual
Prefix:DR
First Name:BRET
Middle Name:JARRET
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:MSC10 5590 1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-5551
Mailing Address - Fax:505-272-6845
Practice Address - Street 1:MSC DEPARTMENT OF PEDIATRICS 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-5551
Practice Address - Fax:505-272-6845
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT14205336-12052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology