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General NPI Number Information
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NPI Number | 1548243728
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Entity Type | Individual
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Provider Name | JOE HOWARD GAY MEDICAL DOCTOR
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 4215 KELSON AVE SUITE E
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City | MARIANNA
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State | FL
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Zip | 32446
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Country | US
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Telephone | 850-526-3434
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Fax | 850-526-7743
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Provider Business Mailing Address
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Address Line | P.O. BOX 5788
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City | MARIANNA
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State | FL
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Zip | 32447
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Country | US
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Telephone | 850-526-8598
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Fax | 850-526-7743
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0057012
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License Number State | FL
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