Healthcare Provider Details

I. General information

NPI: 1528072311
Provider Name (Legal Business Name): JOHN A GABIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N WALNUT ST
CHILLICOTHEE OH
45601-2420
US

IV. Provider business mailing address

272 HOSPITAL RD SUITE 3
CHILLICOTHEE OH
45601-9031
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-4500
  • Fax: 740-779-8495
Mailing address:
  • Phone: 740-779-8234
  • Fax: 740-779-7747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.057767
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: