Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01037710 | IN |
N | 111NI0900X | Internist | 01037710 | IN |
Y | 207R00000X | Internist | 01037710A | IN |
Y | 111NI0900X | Internist | 01037710A | IN |
N | 207RA0401X | Internist - Addiction Medicine | 01037710A | IN |
NPI | 1922159847 |
---|---|
Provider Name | Dr. Gregory Mark French |
First Address | Lafayette, IN 47904-2138 |
Second Address | Lafayette, IN 47904-2138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100217250 | (05) | IN |
E75758 | (02) | IN |