Healthcare Provider Details

I. General information

NPI: 1205802667
Provider Name (Legal Business Name): MATTHEW T GAINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 N MCKENZIE ST
FOLEY AL
36535-2247
US

IV. Provider business mailing address

PO BOX 689022
FRANKLIN TN
37068-9022
US

V. Phone/Fax

Practice location:
  • Phone: 251-949-3711
  • Fax: 251-949-3715
Mailing address:
  • Phone: 251-949-3711
  • Fax: 251-949-3715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number24491
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number18092
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18092
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: