Basic Information
| Provider Information | |||||||||
| NPI: | 1538210935 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEBEL | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3563 RIDGE PARK DRIVE | ||||||||
| Address2: | STE. A | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306640767 | ||||||||
| FaxNumber: | 3306654190 | ||||||||
| Practice Location | |||||||||
| Address1: | 3563 RIDGE PARK DRIVE | ||||||||
| Address2: | STE. A | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306640767 | ||||||||
| FaxNumber: | 3306654190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2007 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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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 | 2084N0400X | 35-066430 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 1841239274 | 01 | OH | PARTNERS PHYSICIAN GROUP TYPE 2 NPI # | OTHER | 2551671 | 01 | OH | PARTNERS PHYSICIAN GROUP MEDICAID # | OTHER | 2031858 | 05 | OH | MEDICAID | 9338635 | 01 | OH | PARTNERS PHYSICIAN GROUP MEDICARE # | OTHER |