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NPI Code Detail

MEDICARE: GERARD DAYLE HENRY M.D.

MEDICARE:   GERARD DAYLE HENRY  M.D.
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
1208800000XUrology Physician15041RLA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00144298OTHERLARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508862905
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARD DAYLE HENRY M.D.
Provider Business Mailing Address
First Line : 2449 HOSPITAL DR
Second Line : STE 280
City : BOSSIER CITY
State : LA
Zip : 71111-1900
Country : US
Telephone Number : 318-212-7850
Fax Number : 318-841-4008
Provider Business Practice Location Address
First Line : 2449 HOSPITAL DR
Second Line : STE 280
City : BOSSIER CITY
State : LA
Zip : 71111-1900
Country : US
Telephone Number : 318-212-7850
Fax Number : 318-841-4008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 03/16/2017

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Directions to “ GERARD DAYLE HENRY M.D.” Practice Location

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