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NPI Code Detail

MEDICARE: JUANITA R GAINES MD

MEDICARE: JUANITA R GAINES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35-047464OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00919613OTHEROHMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801826763
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUANITA R GAINES MD
Provider Business Mailing Address
First Line : 6045 BRIDGETOWN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-3049
Country : US
Telephone Number : 513-981-4105
Fax Number : 513-347-4620
Provider Business Practice Location Address
First Line : 6045 BRIDGETOWN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-3049
Country : US
Telephone Number : 513-981-4105
Fax Number : 513-347-4620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 05/07/2021

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Directions to “ JUANITA R GAINES MD” Practice Location

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