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General NPI Number Information
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NPI Number | 1437372315
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Entity Type | Individual
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Provider Name | ROBERT GAYLE
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | RR 4 BOX 4515
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City | PIEDMONT
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State | MO
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Zip | 63957-9417
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Country | US
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Telephone | 573-223-4235
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Fax |
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Provider Business Mailing Address
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Address Line | RR 1 BOX 155B
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City | PATTERSON
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State | MO
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Zip | 63956-9739
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Country | US
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Telephone | 573-856-4031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2004035745
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License Number State | MO
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