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Organization
JOHN L GAINES JR MD PA
Active
Organization
JOHN L GAINES JR MD PA
Active
Other names
John L Gaines Jr MD
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L GAINES JR. MD (PRESIDENT)
(386) 328-8358
Entity
Organization
Contact information
Practice address
530 ZEAGLER DR, STE A, PALATKA, FL 32177-6855
(386) 328-8358
(386) 325-0635
Mailing address
530 ZEAGLER DR, STE A, PALATKA, FL 32177-6855
(386) 328-8358
(386) 325-0635
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME38167
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065427200
—
FL
01
—
110158966
RAILROAD MEDICARE
FL
01
—
1508847021
INDIV NPI
—
01
—
54048
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
11/15/2006
Last updated
05/29/2008
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