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General NPI Number Information
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NPI Number | 1215010459
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Entity Type | Organization
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Legal Business Name | EDDIE G GAINES MD PC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 2227 DRAKE AVE SW SUITE 6
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City | HUNTSVILLE
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State | AL
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Zip | 35805-5199
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Country | US
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Telephone | 256-882-1881
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Fax | 256-882-3691
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Provider Business Mailing Address
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Address Line | 2227 DRAKE AVE SW SUITE 6
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City | HUNTSVILLE
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State | AL
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Zip | 35805-5199
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Country | US
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Telephone | 256-882-1881
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Fax | 256-882-3691
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Authorized Official
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Title or Position | BILLING MGR
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Name | MONICA COPELAND
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Credential |
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Telephone | 256-882-1881
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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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