Provider Demographics
NPI:1407818180
Name:GAUGLER, MICHAEL F (DOFACOI)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:GAUGLER
Suffix:
Gender:M
Credentials:DOFACOI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 WARM SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-2350
Mailing Address - Country:US
Mailing Address - Phone:814-643-8556
Mailing Address - Fax:814-643-8490
Practice Address - Street 1:900 BRYAN ST STE 7
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2413
Practice Address - Country:US
Practice Address - Phone:814-644-1141
Practice Address - Fax:814-643-9451
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006851L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
100006315OtherRR MEDICARE
PA0014114400003Medicaid
PA741393OtherHIGHMARK
F55739Medicare UPIN
PA0014114400003Medicaid