Individual
RICHARD E GAYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
526 BANKHEAD HWY STE 101, CARROLLTON, GA 30117-2463
(770) 962-3642
(770) 962-3643
Mailing address
455 PHILIP BLVD STE 140, LAWRENCEVILLE, GA 30046-8768
(770) 962-3642
(770) 962-3643
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
96608
GA
208VP0014X
Interventional Pain Medicine Physician
ME73164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1074660
CAQH
FL
01
—
1861400459
NPI
—
01
—
41862
BCBS
FL
01
—
6754544
CIGNA
FL
Enumeration date
08/03/2006
Last updated
12/29/2025
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