Gaines, Beverly M

Gaines, Beverly M is an individual health care provider with primary practice located at 305 W Broadway Suite 104, Louisville KY 40202-2129. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gaines, Beverly M can be contacted via phone (502) 585-2924.

Contact Information

Primary practice address
305 W Broadway Suite 104 Louisville KY 40202-2129
Phone: (502) 585-2924
Fax: (502) 585-2931
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 20974 Kentucky

Profile Details

NPI number 1649350232
LBN Legal business name Gaines, Beverly M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Dec 28th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649350232 NPPES
Kentucky MEDICAID 64209745

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