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NPI Code Detail

MEDICARE: GAYLON PAUL GAUTIER PHARMD

MEDICARE: GAYLON PAUL GAUTIER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist38387TX

General Provider Information

NPI Number : 1235230426
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAYLON PAUL GAUTIER PHARMD
Provider Business Mailing Address
First Line : 6440 SPICED BUTTER RUM ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-1328
Country : US
Telephone Number : 702-653-3213
Fax Number :
Provider Business Practice Location Address
First Line : 6440 SPICED BUTTER RUM ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-1328
Country : US
Telephone Number : 702-653-3213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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