Individual
DR. THEODORE H GAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1251 S CEDAR CREST BLVD, #110, ALLENTOWN, PA 18103-6205
(610) 770-9797
(610) 770-9521
Mailing address
1251 S CEDAR CREST BLVD, #110, ALLENTOWN, PA 18103-6205
(610) 770-9797
(610) 770-9521
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD022099E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00640920
—
PA
01
—
02348200
CAPITAL BLUE CROSS
PA
01
—
0549870
AETNA US HEALTHCARE
PA
Enumeration date
11/16/2005
Last updated
09/16/2010
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