Individual
BRYON L GAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2004 HWY BLVD, SPENCER, IA 51301
(712) 262-6906
Mailing address
2004 HWY BLVD, SPENCER, IA 51301
(712) 262-6906
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
26772
IA
207ND0101X
MOHS-Micrographic Surgery Physician
26772
IA
207NP0225X
Pediatric Dermatology Physician
26772
IA
207NS0135X
Procedural Dermatology Physician
26772
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0268979
—
IA
Enumeration date
05/23/2006
Last updated
11/28/2007
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