Basic Information
| Provider Information | |||||||||
| NPI: | 1346235728 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GAYNIER | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | RENEE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 636930 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199962650 | ||||||||
| FaxNumber: | 4199965165 | ||||||||
| Practice Location | |||||||||
| Address1: | 582 N CABLE RD | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458052133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199962500 | ||||||||
| FaxNumber: | 4199962509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 01/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35083566 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207V00000X | 35083566 | OH | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 000000337143 | 01 | OH | ANTHEM PROVIDER # | OTHER | 2468262 | 05 | OH | MEDICAID | 1134112469 | 01 | GROUP NPI# PRIMARY OFFICE | OTHER | 1669550182 | 01 | GROUP NPI# SATELLITE OFFI | OTHER | P00161875 | 01 | OH | TRAVELERS/MEDICARE # | OTHER |