JEFFREY GAGNON PA NPI 1811137888

NPI Information

Jeffrey Gagnon, PA is a surgical physician assistant in Waterville, ME with 16 years of experience. Jeffrey Gagnon, PA NPI is 1811137888. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: YALE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

180 KENNEDY MEMORIAL DR
SUITE 101
WATERVILLE, ME
ZIP 04901-540
Phone: (207) 861-7874
Fax: (207) 861-4646

The NPI 1811137888 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/3/2009 and was last updated on 3/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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