Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 02002405 | IN |
Y | 111NI0900X | Internist | 02002405 | IN |
N | 207U00000X | Nuclear Medicine Specialist | 02002405 | IN |
NPI | 1417023581 |
---|---|
Provider Name | Dr. Daniel A Gay |
First Address | Greenwood, IN 46143-7241 |
Second Address | Mooresville, IN 46158-1737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 04/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000190965 | ANTHEM IM IDENTIFICATION (01) | IN |
000000277881 | ANTHEM NUC MED ID (01) | IN |
200324060 | (05) | IN |
64030406 | KY MEDICAID (01) | KY |