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General NPI Number Information
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NPI Number | 1164660783
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Entity Type | Organization
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Legal Business Name | JOHN F. GADDIS
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | FACTORY ROAD
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City | EAST MACHIAS
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State | ME
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Zip | 04630-0189
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Country | US
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Telephone | 207-255-3338
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Fax | 307-355-0534
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Provider Business Mailing Address
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Address Line | P.O. BOX 189 FACTORY ROAD
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City | EAST MACHIAS
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State | ME
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Zip | 04630-0189
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Country | US
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Telephone | 207-255-3338
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Fax | 207-255-0534
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Authorized Official
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Title or Position | OWNER
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Name | JOHN F. GADDIS
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Credential | D.O.
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Telephone | 207-255-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 1034
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License Number State | ME
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