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Organization
SAM GAINES P C
Active
Organization
SAM GAINES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM GAINES MD (OWNER)
(217) 341-1726
Entity
Organization
Contact information
Practice address
120 N 11TH ST, SPRINGFIELD, IL 62703-1002
(217) 544-9858
Mailing address
509 COLBROOK DR, SPRINGFIELD, IL 62702-3384
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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