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General NPI Number Information
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NPI Number | 1477539625
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Entity Type | Individual
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Provider Name | RONALD W GREGORY D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 1400 PENNA AVE
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City | TYRONE
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State | PA
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Zip | 16686-1728
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Country | US
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Telephone | 814-684-2100
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Fax | 814-684-5828
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Provider Business Mailing Address
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Address Line | 1414 9TH AVE STATION MEDICAL CENTER
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City | ALTOONA
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State | PA
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Zip | 16602-2454
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Country | US
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Telephone | 814-946-1655
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Fax | 814-949-7616
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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 | OS007287E
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License Number State | PA
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