NPI 1558413807 · live from the CMS NPI Registry
Thaddeus B Gaillard, MD
Obstetrics & Gynecology, Gynecology in Southaven, MS. National Provider Identifier 1558413807, active.
NPI record
| NPI | 1558413807 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Obstetrics & Gynecology, Gynecology 207VG0400X |
| Practice location | 401 Southcrest Circle, Suite 102, Southaven, MS 38671 |
| Practice phone | 662-349-4377 |
| Mailing address | Po Box 381257, Germantown, TN 38183 |
| Enumerated | January 17, 2007 |
| Last updated | February 15, 2012 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Obstetrics & Gynecology, Gynecology | 207VG0400X | 15990 (TN) |
| Obstetrics & Gynecology, Gynecology primary | 207VG0400X | 11279 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.