Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 036-130301 | IL |
N | 207RR0500X | Rheumatology | 47924 | MN |
Y | 207RR0500X | Rheumatology | MD197461 | OR |
NPI | 1134289390 |
---|---|
Provider Name | Laura Gregg |
First Address | Eugene, OR 97440-1648 |
Second Address | Springfield, OR 97477-7126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 21/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116417100 | (05) | MN |
H07715 | (02) |