Basic Information
| Provider Information | |||||||||
| NPI: | 1194796169 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAINEY | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1210 KY HIGHWAY 36 E | ||||||||
| Address2: | ATTN: DAVID ASHER | ||||||||
| City: | CYNTHIANA | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410317490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592344494 | ||||||||
| FaxNumber: | 8592344498 | ||||||||
| Practice Location | |||||||||
| Address1: | 1210 KY HIGHWAY 36 E | ||||||||
| Address2: | ATTN: DAVID ASHER | ||||||||
| City: | CYNTHIANA | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410317490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592344494 | ||||||||
| FaxNumber: | 8592344498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 10/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 22283 | KY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 22283 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 64222839 | 05 | KY | MEDICAID | 000000229306 | 01 | KY | BLUECROSS BLUESHIELD | OTHER | K014761 | 01 | MEDICARE NUMBER | OTHER |