Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 013212 | MO |
NPI | 1063435089 |
---|---|
Provider Name | Dr. William D Gay |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 17/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
400971404 | (05) | MO |
T92345 | (02) |