Healthcare Provider Details

I. General information

NPI: 1538148713
Provider Name (Legal Business Name): LOUIS CARL GADOL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 N TOMS ST
RUTHERFORDTON NC
28139-2500
US

IV. Provider business mailing address

270 N TOMS ST
RUTHERFORDTON NC
28139-2500
US

V. Phone/Fax

Practice location:
  • Phone: 828-287-8890
  • Fax: 828-287-3102
Mailing address:
  • Phone: 828-287-8890
  • Fax: 828-287-3102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1176
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: