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General NPI Number Information
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NPI Number | 1528089547
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Entity Type | Individual
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Provider Name | LEONARD E. GATELY III MD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 3421 N CAUSEWAY BLVD STE 202
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City | METAIRIE
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State | LA
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Zip | 70002-3759
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Country | US
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Telephone | 504-832-6612
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Fax | 504-832-6613
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Provider Business Mailing Address
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Address Line | 3421 N CAUSEWAY BLVD STE 202
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City | METAIRIE
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State | LA
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Zip | 70002-3759
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Country | US
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Telephone | 504-832-6612
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Fax | 504-832-6613
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 013671
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License Number State | LA
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