Provider Demographics
NPI:1063733368
Name:GAHAGAN, JAMES REED (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:REED
Last Name:GAHAGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-453-3281
Mailing Address - Fax:850-453-4491
Practice Address - Street 1:4929 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-3229
Practice Address - Country:US
Practice Address - Phone:850-453-3281
Practice Address - Fax:850-453-4491
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine