Provider Demographics
NPI:1265696918
Name:WHITFIELD, GAYLE D (CO BOCO)
Entity type:Individual
Prefix:MR
First Name:GAYLE
Middle Name:D
Last Name:WHITFIELD
Suffix:
Gender:
Credentials:CO BOCO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:121 21ST AV N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5228
Mailing Address - Country:US
Mailing Address - Phone:615-327-0231
Mailing Address - Fax:615-327-0238
Practice Address - Street 1:121 21ST AV N
Practice Address - Street 2:SUITE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5228
Practice Address - Country:US
Practice Address - Phone:615-327-0231
Practice Address - Fax:615-327-0238
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN189335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3500631Medicaid
TN3500631Medicaid