# MICHAEL J. GREGSON, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083983647
- **Authorized official:** MICHAEL J. GREGSON M.D., P.A. (PHYSICIAN, OWNER)
- **Authorized official phone:** (208) 232-8300

## Contact information

- **Practice address:** 1950 E CLARK ST, SUITE C, POCATELLO, ID 83201-3314
- **Practice address phone:** (208) 232-8300
- **Practice address fax:** (208) 232-8303
- **Mailing address:** PO BOX 4907, POCATELLO, ID 83205-4907
- **Mailing address phone:** (208) 232-8300
- **Mailing address fax:** (208) 232-8303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M3289 | ID | Yes |

## Other

- **Enumeration date:** 12/27/2011
- **Last updated:** 12/27/2011