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General NPI Number Information
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NPI Number | 1083650105
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Entity Type | Individual
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Provider Name | DANIEL JAMES GAVIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 911 BYPASS RD
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City | PIKEVILLE
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State | KY
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Zip | 41501-1602
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Country | US
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Telephone | 806-430-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 730 FROST BOTTOM RD
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City | OLIVER SPRINGS
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State | TN
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Zip | 37840-6006
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Country | US
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Telephone | 865-696-4104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | C2791
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD37069
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License Number State | TN
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