Basic Information
| Provider Information | |||||||||
| NPI: | 1619949872 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GAMACHE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2804 CHAPLIN DR | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123384112 | ||||||||
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| Practice Location | |||||||||
| Address1: | HIGHWAY 71 SOUTH | ||||||||
| Address2: | |||||||||
| City: | SPIRIT LAKE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7123361230 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 207Q00000X | 22168 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.