Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036080081 | IL |
N | 208600000X | Surgeon | 036080081 | IL |
N | 208200000X | Surgeon | 267232 | NY |
N | 208600000X | Surgeon | 267232 | NY |
N | 208200000X | Surgeon | MD430446 | PA |
N | 208600000X | Surgeon | MD430446 | PA |
N | 2086S0102X | Surgical Critical Care | 267232 | NY |
N | 2086S0127X | Trauma Surgeon | 267232 | NY |
N | 2086S0127X | Trauma Surgeon | 4301104558 | MI |
Y | 2086S0127X | Trauma Surgeon | MD430446 | PA |
NPI | 1073561635 |
---|---|
Provider Name | Dr. James S Gregory |
First Address | Bloomsburg, PA 17815-7701 |
Second Address | Bloomsburg, PA 17815-7701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 26/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0015135930002 | (05) | PA |
03537395 | (05) | NY |