MEDICARE: DR. ROSY GEHLOT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	055225	GA
2	208000000X	Pediatrics Physician	C1-0005970	DE

General Provider Information

NPI Number	:	1568445138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSY GEHLOT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 72103
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31708-2103
Country	:	US
Telephone Number	:	229-435-2502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 PALMYRA RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31701-1574
Country	:	US
Telephone Number	:	229-435-2502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	07/08/2007

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