Healthcare Provider Details

I. General information

NPI: 1265617682
Provider Name (Legal Business Name): JAMES RICHARD GASKELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 W UNION ST
ATHENS OH
45701-2310
US

IV. Provider business mailing address

278 W UNION ST
ATHENS OH
45701-2310
US

V. Phone/Fax

Practice location:
  • Phone: 740-592-4431
  • Fax: 740-594-2370
Mailing address:
  • Phone: 740-592-4431
  • Fax: 740-594-2370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.032301
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: