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Organization

GAINES & BANDAY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAM GAINES M.D. (PHYSICIAN)
(217) 793-5266
Entity
Organization

Contact information

Practice address
301 N 8TH ST, SPRINGFIELD, IL 62701-1041
(217) 544-6464
Mailing address
509 COLBROOK DR, SPRINGFIELD, IL 62702-3384
(217) 793-5266

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
04/01/2010
Last updated
07/15/2010
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