Provider Demographics
NPI:1124088620
Name:GARDNER, JOHN PIERRE (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PIERRE
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 VANDERBILT PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1736
Mailing Address - Country:US
Mailing Address - Phone:828-274-9920
Mailing Address - Fax:828-274-9924
Practice Address - Street 1:1 VANDERBILT PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1766
Practice Address - Country:US
Practice Address - Phone:828-274-9920
Practice Address - Fax:828-274-9924
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD6798OtherMEDCOST
NC2004787AOtherGHI
NCP00163043OtherPALMETTO
NC3626378OtherCIGNA
NC1306FOtherBCBS
NC2195227OtherFIRST HEALTH
NC2203524OtherUNITED
NC5332850001OtherPALMETTO GBS
NC2004787AOtherGHI
NC2004787AMedicare ID - Type Unspecified
NC3626378OtherCIGNA