Healthcare Provider Details

I. General information

NPI: 1912839937
Provider Name (Legal Business Name): GARY LAIL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 POTOMAC STREET
AURORA CO
80011
US

IV. Provider business mailing address

143 CORAL KEYS VILLAS NE
CALGARY ALBERTA
T3J3L7
CA

V. Phone/Fax

Practice location:
  • Phone: 303-360-3562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: