Provider Demographics
NPI:1780707299
Name:GAINES, GREGORY CYRUS (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:CYRUS
Last Name:GAINES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:108 NW 76TH DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6652
Mailing Address - Country:US
Mailing Address - Phone:352-333-9600
Mailing Address - Fax:352-333-9606
Practice Address - Street 1:108 NW 76TH DR
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6652
Practice Address - Country:US
Practice Address - Phone:352-333-9600
Practice Address - Fax:352-333-9606
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2016-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME764022086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH45232Medicare UPIN