Provider Demographics
NPI:1497778047
Name:GAINES, MICHAEL GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GENE
Last Name:GAINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:GAINES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MS
Mailing Address - Street 1:256 OXFORD EXCHANGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-3453
Mailing Address - Country:US
Mailing Address - Phone:256-835-0076
Mailing Address - Fax:256-831-4808
Practice Address - Street 1:256 OXFORD EXCHANGE BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-3453
Practice Address - Country:US
Practice Address - Phone:256-835-0076
Practice Address - Fax:256-831-4808
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9386207Q00000X
GA22762207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine