Healthcare Provider Details

I. General information

NPI: 1750548707
Provider Name (Legal Business Name): GAYLA J HERBEL MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEDICAL CENTER DR SUITE 230
NEWTON KS
67114-7808
US

IV. Provider business mailing address

800 MEDICAL CENTER DR SUITE 230
NEWTON KS
67114-7808
US

V. Phone/Fax

Practice location:
  • Phone: 316-283-7200
  • Fax: 316-283-7211
Mailing address:
  • Phone: 316-283-7200
  • Fax: 316-283-7211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0432830
License Number StateKS

VIII. Authorized Official

Name: DR. GAYLA JEAN HERBEL
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 316-283-7200