Healthcare Provider Details

I. General information

NPI: 1588632079
Provider Name (Legal Business Name): GREGORY LEE GARNETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S CAMPUS AVE
OXFORD OH
45056-2487
US

IV. Provider business mailing address

421 S CAMPUS AVE
OXFORD OH
45056-2487
US

V. Phone/Fax

Practice location:
  • Phone: 513-529-3000
  • Fax: 513-529-1892
Mailing address:
  • Phone: 513-529-3000
  • Fax: 513-529-1892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number35.061076
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: