Provider Demographics
NPI:1104026806
Name:JOE H GAY, MD
Entity Type:Organization
Organization Name:JOE H GAY, MD
Other - Org Name:CHIPOLA MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:H
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-526-3434
Mailing Address - Street 1:4215 KELSON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-6555
Mailing Address - Country:US
Mailing Address - Phone:850-526-3434
Mailing Address - Fax:850-526-7743
Practice Address - Street 1:4230 HOSPITAL DR
Practice Address - Street 2:SUITE 210
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-1934
Practice Address - Country:US
Practice Address - Phone:850-526-3434
Practice Address - Fax:850-526-7743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057012207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty