Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 013213 | GA |
N | 207QA0505X | Family Doctor - Adult Medicine | 013213 | GA |
NPI | 1265418503 |
---|---|
Provider Name | Dr. William Henry Gainey |
First Address | Thomasville, GA 31799-1378 |
Second Address | Thomasville, GA 31792-7128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 14/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000195038C | (05) | GA |
000195308A | (05) | GA |
D29524 | (02) | GA |