# D RAY GASKIN JR MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366881641
- **Authorized official:** DANIEL RAY GASKIN JR. M.D. (OWNER)
- **Authorized official phone:** (912) 352-9902

## Contact information

- **Practice address:** 315 COMMERCIAL DR STE B3, SAVANNAH, GA 31406-3631
- **Practice address phone:** (912) 352-9902
- **Practice address fax:** (912) 352-9960
- **Mailing address:** 315 COMMERCIAL DR STE B3, SAVANNAH, GA 31406-3631
- **Mailing address phone:** (912) 352-9902
- **Mailing address fax:** (912) 352-9960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LPC002856 | GA | — |
| 174400000X | Specialist | 022469 | GA | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 028117 | GA | Yes |

## Other

- **Enumeration date:** 06/19/2013
- **Last updated:** 06/19/2013