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General NPI Number Information
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NPI Number | 1417349580
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Entity Type | Individual
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Provider Name | JASMINE P GAINES M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2015
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 801 S UNIVERSITY BLVD STE D
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City | MOBILE
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State | AL
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Zip | 36609-2949
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Country | US
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Telephone | 251-344-1964
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Fax | 251-344-2227
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Provider Business Mailing Address
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Address Line | 1542 TULANE AVE BOX T4M-2
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2865
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Country | US
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Telephone | 504-568-3792
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Fax | 504-568-2127
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34737
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34737
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34737
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License Number State | AL
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