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General NPI Number Information
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NPI Number | 1194721563
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Entity Type | Individual
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Provider Name | THOMAS RICHARD DEGREGORY D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 372 LAKEWOOD RD
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City | GREENSBURG
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State | PA
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Zip | 15601-9769
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Country | US
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Telephone | 724-219-4489
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Fax | 724-832-1385
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Provider Business Mailing Address
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Address Line | 506 ATHENA DR
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City | DELMONT
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State | PA
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Zip | 15626-1005
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Country | US
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Telephone | 724-468-6869
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Fax | 724-468-6207
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS003093L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | OS003093L
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License Number State | PA
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