Basic Information
| Provider Information | |||||||||
| NPI: | 1558349407 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAUL | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3411 MACGREGOR DR | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809223100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193025938 | ||||||||
| FaxNumber: | 7195547227 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 COCHRANE CIR | ||||||||
| Address2: | BLDG 7500 | ||||||||
| City: | FT CARSON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80913 | ||||||||
| CountryCode: | UY | ||||||||
| TelephoneNumber: | 7195267844 | ||||||||
| FaxNumber: | 7195267984 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083A0100X | 01042024A | IN | X | Allopathic & Osteopathic Physicians | Preventive Medicine | Aerospace Medicine | 2083X0100X | 01042024A | IN | X | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.