Individual
DR. JEFFREY T GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11 FRIENDSHIP ST, NEWPORT, RI 02840-2209
(401) 845-1593
Mailing address
11 FRIENDSHIP ST, NEWPORT, RI 02840-2209
(401) 845-1593
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12890
RI
207P00000X
Emergency Medicine Physician
MD 26740
OR
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301083771
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U400167682
MEDICARE NGS
RI
Enumeration date
01/23/2006
Last updated
01/15/2015
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