MEDICARE: LESLIE GAYLOR

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	363L00000X	Nurse Practitioner	1-136700	AL

General Provider Information

NPI Number	:	1558736322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE GAYLOR

Provider Business Mailing Address
First Line	:	PO BOX 11407
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35202-1407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2006 BROOKWOOD MEDICAL CTR DR STE 604
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6845
Country	:	US
Telephone Number	:	205-877-5113
Fax Number	:

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

Provider Enumeration Date	:	12/05/2015
Last Update Date	:	06/22/2026

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Directions to “ LESLIE GAYLOR ” Practice Location

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