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NPI Code Detail

MEDICARE: JERRY GLEN GREGORY MD

MEDICARE: JERRY GLEN GREGORY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician23117NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21393AOTHERNCCA BCBSNC GRP # 015HF

General Provider Information

NPI Number : 1538198254
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY GLEN GREGORY MD
Provider Business Mailing Address
First Line : 800 FLEMING ST
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28791-3528
Country : US
Telephone Number :
Fax Number : 828-693-9560
Provider Business Practice Location Address
First Line : 356 BILTMORE AVE
Second Line :
City : ASHEVILLE
State : NC
Zip : 28801-4516
Country : US
Telephone Number : 828-258-3500
Fax Number : 828-258-8816
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/09/2007

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