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Individual

CHARLES E GAINES

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7013
(423) 431-7130
Mailing address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7013
(423) 431-7130

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DO01281
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3306064
TN
01
4109591
BCBS
TN
Enumeration date
04/26/2006
Last updated
07/08/2007
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