Organization
BEVERLY M GAINES, MD & ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY M GAINES M.D. (PRESIDENT & CEO)
(502) 585-2924
Entity
Organization
Contact information
Practice address
801 BARRET AVE, SUITE 314, LOUISVILLE, KY 40204-1747
(502) 585-2924
(502) 585-2931
Mailing address
801 BARRET AVE, SUITE 314, LOUISVILLE, KY 40204-1747
(502) 585-2924
(502) 585-2931
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65909228
—
KY
Enumeration date
10/17/2006
Last updated
01/31/2019
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