Gabriel Factora, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

35-041813 Issued in OH

Practice address

200 Saint Clair Ave
Saint Marys, OH 45885-2400

Phone

(419) 394-3335

Fax

(419) 394-8485

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JTDM Family Practice LLC

  • Family Medicine Physician
  • Saint Marys, OH
  • NPI 1184652539
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164450052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335",
            "fax_number": "419-394-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335",
            "fax_number": "419-394-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACTORA",
        "first_name": "GABRIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35-041813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0517864",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alecksa Noelle Engle, APRN-CNP
• Essex Healthcare Corp (St. Mary's Living Center-Lab)
• Essex Healthcare Corporation (St. Marys Living Center)
• Essex Healthcare Corporation (ST. Mary's Living Center)
• Kurt Lynden Eversman, LPN
• Kendra Ferrall, LMT
• Hannah Marie Finamore
• Terry Lyn Fisher
• Jeffrey Dean Fleagle, D.D.S.
• Foot and Ankle Centers of Ohio, Inc.

• Anatomic Pathology & Clinical Pathology Physician in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Anatomic Pathology & Clinical Pathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.