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Individual

KENNETH M GAINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
222 N 5TH ST, SUITE 201, MARTINS FERRY, OH 43935-1582
(740) 633-6671
Mailing address
222 N 5TH ST, SUITE 201, MARTINS FERRY, OH 43935-1582

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
20425
WV
207W00000X
Ophthalmology Physician
Primary
3584204
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10439701
CAQH
OH
05
2003963000
WV
05
2524209
OH
Enumeration date
01/23/2007
Last updated
10/30/2007
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