Provider Demographics
NPI:1508028093
Name:VANOURNY, JAIME J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:J
Last Name:VANOURNY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:J
Other - Last Name:REILAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1072 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7488
Mailing Address - Country:US
Mailing Address - Phone:704-671-1094
Mailing Address - Fax:704-671-1095
Practice Address - Street 1:959 COX RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3420
Practice Address - Country:US
Practice Address - Phone:704-866-7576
Practice Address - Fax:704-866-0106
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR8536207N00000X
NC201101796207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology