Individual
DR. CARL D GANDOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 JAMES SIMPSON JR WAY, SUITE 201, COVINGTON, KY 41011-0801
(859) 655-8980
(859) 655-8981
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 655-8980
(859) 655-8981
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35043698
OH
207R00000X
Internal Medicine Physician
Primary
45251
KY
207R00000X
Internal Medicine Physician
TP405
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401578
—
OH
05
—
64785306
—
KY
Enumeration date
12/20/2005
Last updated
09/12/2018
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