Provider Demographics
NPI:1700327103
Name:GAYLE, JOVAN ANDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOVAN
Middle Name:ANDRE
Last Name:GAYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-623-5220
Mailing Address - Fax:501-623-1546
Practice Address - Street 1:1 MERCY LN STE 401
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6441
Practice Address - Country:US
Practice Address - Phone:501-623-5220
Practice Address - Fax:501-623-1546
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16149207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease