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1518958842

NPI Code Detail

MEDICARE: DR. GREGORY JULIAN MINCEY MD

MEDICARE: DR. GREGORY JULIAN MINCEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	13516	SC
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	0026851	NC
3	207W00000X	Ophthalmology Physician	0026851	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	180020412	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FH2000325	OTHER	NC	FIRSTCAROLINACARE
3	232483	OTHER	NC	MAMSI
4	59512	OTHER	NC	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0838886	OTHER	NC	UNITED HEALTHCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	43011	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1518958842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY JULIAN MINCEY MD

Provider Business Mailing Address
First Line	:	2170 MIDLAND RD
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-2927
Country	:	US
Telephone Number	:	910-295-2100
Fax Number	:	910-295-3625

Provider Business Practice Location Address
First Line	:	2170 MIDLAND RD
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-2927
Country	:	US
Telephone Number	:	910-295-2100
Fax Number	:	910-295-3625

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	01/28/2021

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Directions to “ DR. GREGORY JULIAN MINCEY MD” Practice Location

Language	Start Address	Practice Location

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