Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD.306703 | LA |
NPI | 1225320906 |
---|---|
Provider Name | Dr. Eric Mckenzie Greber |
First Address | Thibodaux, LA 70302-0028 |
Second Address | Thibodaux, LA 70301-5009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 27/02/2018 |