MEDICARE: CARLA GAYLE MD

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
1	208000000X	Pediatrics Physician	09234	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487658159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA GAYLE MD

Provider Business Mailing Address
First Line	:	298 HENRY CLAY AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-5720
Country	:	US
Telephone Number	:	504-896-9827
Fax Number	:	504-894-5370

Provider Business Practice Location Address
First Line	:	3512 LOUISA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-5807
Country	:	US
Telephone Number	:	504-948-2873
Fax Number	:	504-948-9292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/08/2007

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Directions to “ CARLA GAYLE MD” Practice Location

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