Healthcare Provider Details
I. General information
NPI: 1629648811
Provider Name (Legal Business Name): JAMES GABLE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2021
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1430 HARPER ST STE B
AUGUSTA GA
30901-0619
US
IV. Provider business mailing address
1430 HARPER ST STE B
AUGUSTA GA
30901-0619
US
V. Phone/Fax
- Phone: 706-724-5451
- Fax: 706-724-9562
- Phone: 706-724-5451
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
JENNIFER
C
FINLEY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 706-724-5451