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General NPI Number Information
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NPI Number | 1801936836
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Entity Type | Individual
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Provider Name | MARION ANDERSON GREGG II M.D., M.P.H, M.B.A
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 2080 CHILD ST DEPT 5000
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City | JACKSONVILLE
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State | FL
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Zip | 32214-5000
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Country | US
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Telephone | 904-524-9109
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Fax |
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Provider Business Mailing Address
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Address Line | 2080 CHILD ST DEPT 5000
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City | JACKSONVILLE
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State | FL
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Zip | 32214-5000
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Country | US
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Telephone | 904-524-9109
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Fax |
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 0101237427
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101237427
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License Number State | VA
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