Individual
JILL A GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 HIGHLAND AVE SE, SUITE 200, ROANOKE, VA 24013-2201
(540) 982-8881
(540) 982-0501
Mailing address
21 HIGHLAND AVE SE, SUITE 200, ROANOKE, VA 24013-2201
(540) 982-8881
(540) 982-0501
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
200300786
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89135F6
—
NC
05
—
N0078A
—
SC
01
—
P00391091
RAILROAD MEDICARE
NC
Enumeration date
10/24/2006
Last updated
10/12/2011
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