Provider Demographics
NPI:1013194075
Name:GAYLA J. HERBEL, LLC
Entity Type:Organization
Organization Name:GAYLA J. HERBEL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KINGSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-283-6655
Mailing Address - Street 1:700 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9013
Mailing Address - Country:US
Mailing Address - Phone:316-283-6655
Mailing Address - Fax:316-283-3199
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 140
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9013
Practice Address - Country:US
Practice Address - Phone:316-283-6655
Practice Address - Fax:316-283-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-32830207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty