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General NPI Number Information
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NPI Number | 1760479950
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Entity Type | Individual
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Provider Name | RICHARD E GAYLE D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 07/13/2007
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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 | 573-223-4233
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Fax | 573-223-2136
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Provider Business Mailing 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 | 573-223-4233
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Fax | 573-223-2136
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 31158
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License Number State | MO
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