Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 27041 | OK |
NPI | 1912132390 |
---|---|
Provider Name | Dr. James Richard Gregory |
First Address | Oklahoma City, OK 73104-5008 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2009 |
Last Update Date | 06/08/2015 |