Jerry L Gastineau
Family Doctor Medical Geneticist
1505 W Elk Ave Suite 2
Elizabethton
, Tennessee 37643-2848
Jerry L Gastineau
Family Doctor Medical Geneticist
1505 W Elk Ave Suite 2
Elizabethton
, Tennessee 37643-2848
(423) 543-7500
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About
Features
Specialties
- Medical Geneticist
- Family Doctor
Languages spoken
- English
Location
First Address
- Jerry L Gastineau
- 1505 W Elk Ave Suite 2
- Elizabethton, TN
- Zip : 37643-2848
- Fax : (423) 543-7500
- Phone : (423) 543-1261
Second Address
- Jerry L Gastineau
- 1505 W Elk Ave Suite 2
- Elizabethton, TN
- Zip : 37643-2848
- Fax : (423) 543-7500
- Phone : (423) 543-1261
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Is Jerry L Gastineau a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 170100000X | Medical Geneticist | MD7688 | TN |
| Y | 207Q00000X | Family Doctor | 7688 | TN |
National Provider Identifier
| NPI | 1124118971 |
|---|---|
| Provider Name | Jerry L Gastineau |
| First Address | Elizabethton, TN 37643-2848 |
| Second Address | Elizabethton, TN 37643-2848 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/10/2006 |
| Last Update Date | 18/12/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 201575 | BLUECARE (01) | TN |
| 3152032 | (05) | TN |
| 4360576 | BCBS (01) | TN |
| BLUECROSS | 201575 (01) | TN |
| BO2385 | (02) | TN |
| TN0102 | AMERICHOICE (01) | TN |
| TN0102 | JOHNDEERE (01) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.