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General NPI Number Information
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NPI Number | 1588693840
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Entity Type | Individual
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Provider Name | JAMES S GWINN JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 2601 KENTUCKY AVE SUITE 301
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City | PADUCAH
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State | KY
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Zip | 42003-3817
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Country | US
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Telephone | 270-575-3113
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Fax | 270-575-3135
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Provider Business Mailing Address
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Address Line | POST OFFICE BOX 7648
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City | PADUCAH
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State | KY
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Zip | 42002-7648
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Country | US
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Telephone | 800-467-2392
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Fax | 812-471-6650
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 19484
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License Number State | KY
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