Provider Demographics
NPI:1750368221
Name:GAGE, JOHN F (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:GAGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:218 FOUST ST
Mailing Address - Street 2:STE C
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5476
Mailing Address - Country:US
Mailing Address - Phone:336-625-2333
Mailing Address - Fax:336-625-5511
Practice Address - Street 1:514 N BROAD ST
Practice Address - Street 2:
Practice Address - City:SEAGROVE
Practice Address - State:NC
Practice Address - Zip Code:27341-8583
Practice Address - Country:US
Practice Address - Phone:336-873-8045
Practice Address - Fax:336-873-9074
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2020-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9501245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8934259Medicaid
NC2215538AMedicare PIN
NCD05653Medicare UPIN