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Individual

GAYLA JANINE DILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1364 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(770) 761-7171
(770) 761-7179
Mailing address
1364 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(770) 761-7171
(770) 761-7179

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
035241
GA
208600000X
Surgery Physician
Primary
35241
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00489255C
GA
Enumeration date
07/22/2006
Last updated
11/14/2014
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