Provider Demographics
NPI:1316994486
Name:GAILLARD, HENRY MOREL (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:MOREL
Last Name:GAILLARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2222 GOVERNORS BEND ROAD
Mailing Address - Street 2:HEALTH SERVICES, INC.
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-1371
Mailing Address - Country:US
Mailing Address - Phone:256-539-2450
Mailing Address - Fax:256-539-2450
Practice Address - Street 1:2222 GOVERNORS BEND ROAD
Practice Address - Street 2:HEALTH SERVICES, INC.
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-1371
Practice Address - Country:US
Practice Address - Phone:256-539-2450
Practice Address - Fax:256-539-2450
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL21348207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF05192Medicare UPIN