Gayle Marie McDonald, ATC

Individual provider Active NPI Athletic Trainer · Henderson, TN

NPI 1275640583 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1275640583
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
0000000085 (TN)
Practice address
158 E Main St
Freed-Hardeman University
Henderson, TN 38340-2306
Phone
(731) 989-6046
Fax
(731) 983-3117
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0000000085TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Freed-Hardeman University Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0000000085 TN Yes

Addresses

Primary practice location

158 E Main St
Freed-Hardeman University
Henderson, TN 38340-2306

Mailing address

728 Hearn St
Henderson, TN 38340-2502
Phone (731) 989-7578

Other providers in Henderson, TN

All providers in Henderson, TN · Athletic Trainer in Tennessee

Sources for this page

Verify at the official NPI Registry.