Healthcare Provider Details

I. General information

NPI: 1013061084
Provider Name (Legal Business Name): GREGORY TRUITT SHERR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 NW 64TH TER SUITE A
GAINESVILLE FL
32605-4243
US

IV. Provider business mailing address

1121 NW 64TH TER SUITE A
GAINESVILLE FL
32605-4243
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-3583
  • Fax: 352-331-3669
Mailing address:
  • Phone: 352-331-3583
  • Fax: 352-331-3669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number48216
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME128749
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: