Provider Demographics
NPI:1194766162
Name:GARDNER, JAMES LARIMER III (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LARIMER
Last Name:GARDNER
Suffix:III
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:150 N NEW CASTLE ST
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1019
Mailing Address - Country:US
Mailing Address - Phone:724-946-3564
Mailing Address - Fax:724-946-2156
Practice Address - Street 1:150 N NEW CASTLE ST
Practice Address - Street 2:
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-1019
Practice Address - Country:US
Practice Address - Phone:724-946-3564
Practice Address - Fax:724-946-2156
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2021-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD426144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine