Gaillard, Wendell Elliott

Gaillard, Wendell Elliott is an sole proprietor health care provider with primary practice located at 727 Center St , Columbus GA 31901. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gaillard, Wendell Elliott can be contacted via phone (706) 660-6500.

Contact Information

Primary practice address
727 Center St Columbus GA 31901
Fax: (706) 660-6456
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 054146 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 7516 Alabama
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 54149 Georgia

Profile Details

NPI number 1457412637
LBN Legal business name Gaillard, Wendell Elliott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Feb 3rd, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457412637 NPPES
Georgia Other 90-0137146 BLUE CROSS
Georgia MEDICAID 104594099A BLUE CROSS

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