1780654418 NPI number — DR. CARL JOHN GESSLER JR. M.D.

Table of content: (NPI 1710732516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780654418 NPI number — DR. CARL JOHN GESSLER JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GESSLER
Provider First Name:
CARL
Provider Middle Name:
JOHN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780654418
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4810 WHITESPORT CIR SW STE 217
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-7420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-489-5040
Provider Business Mailing Address Fax Number:
256-489-5074

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4810 WHITESPORT CIR SW STE 217
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-7420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-489-5040
Provider Business Practice Location Address Fax Number:
256-489-5074
Provider Enumeration Date:
01/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  13167 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112355 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25-10119 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 51033800 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 112364 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51049245 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 112352 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 270737 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4003542 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 51049343 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: P00765706 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 060037252 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112362 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51049246 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 000033800 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112358 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112359 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51049342 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51598408 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 0068479 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 51049244 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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