Provider Demographics
NPI:1114924941
Name:GAUL, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:GAUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:J
Other - Last Name:GAUL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1205 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1223
Mailing Address - Country:US
Mailing Address - Phone:215-757-5800
Mailing Address - Fax:215-757-3660
Practice Address - Street 1:1205 LANGHORNE-NEWTOWN RD. SUITE #402
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1223
Practice Address - Country:US
Practice Address - Phone:215-757-5800
Practice Address - Fax:215-757-3660
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030914E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009684450005Medicaid
PA0009684450005Medicaid
BU476412Medicare ID - Type Unspecified