MEDICARE: BRANDON TAYLOR GAMBILL

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	235Z00000X	Speech-Language Pathologist	30000714	NC

General Provider Information

NPI Number	:	1750247060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON TAYLOR GAMBILL

Provider Business Mailing Address
First Line	:	901 W MAIN ST
Second Line	:
City	:	YADKINVILLE
State	:	NC
Zip	:	27055-7807
Country	:	US
Telephone Number	:	855-983-0488
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 W MAIN ST
Second Line	:
City	:	YADKINVILLE
State	:	NC
Zip	:	27055-7807
Country	:	US
Telephone Number	:	855-983-0488
Fax Number	:

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

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	01/08/2026

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Directions to “ BRANDON TAYLOR GAMBILL ” Practice Location

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