Provider Demographics
NPI:1356603187
Name:GASTWIRT, JAIME PIERCEY (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:PIERCEY
Last Name:GASTWIRT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:LYNN
Other - Last Name:PIERCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:34730 BOB WILSON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-3300
Mailing Address - Country:US
Mailing Address - Phone:619-532-7300
Mailing Address - Fax:
Practice Address - Street 1:2005 KNIGHT LANE, BLDG H
Practice Address - Street 2:NAVY MEDICINE SUPPORT ATTN: MEDICAL STAFF SERVICES
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32212-0140
Practice Address - Country:US
Practice Address - Phone:619-532-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127026207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty