Dillard, Gayla Janine
Dillard, Gayla Janine is an sole proprietor health care provider with primary practice located at 1364 Wellbrook Cir Ne , Conyers GA 30012-3872. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Dillard, Gayla Janine can be contacted via phone (770) 761-7171.Contact Information
Primary practice address
1364 Wellbrook Cir Ne
Conyers GA 30012-3872
Phone: (770) 761-7171
Fax: (770) 761-7179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 035241 | Georgia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 35241 | Georgia |
Profile Details
| NPI number | 1649291659 |
|---|---|
| LBN Legal business name | Dillard, Gayla Janine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 22nd, 2006 |
| Last updated | Nov 14th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649291659 | NPPES |
| Georgia | MEDICAID | 00489255C |
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