Gaines, Eddie Leon

Gaines, Eddie Leon is an individual health care provider with primary practice located at 42145 N Fairgreen Ct , Anthem AZ 85086-1066. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Gaines, Eddie Leon can be contacted via phone (575) 405-7697.

Contact Information

Primary practice address
42145 N Fairgreen Ct Anthem AZ 85086-1066
Phone: (575) 405-7697
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 94250 New Mexico
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 94250 New Mexico

Profile Details

NPI number 1942268156
LBN Legal business name Gaines, Eddie Leon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Mar 27th, 2019 - about 6 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 1942268156 NPPES
New Mexico MEDICAID 26189

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