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Organization
GARY GREGERSON, M.D., P.A.
Active
Organization
GARY GREGERSON, M.D., P.A.
Active
Other names
Advanced Specialty Care For Women
Organization subpart
No
Provider details
NPI number
Authorized official
GARY NED GREGERSON (PRESIDENT)
(208) 468-9400
Entity
Organization
Contact information
Practice address
1611 12TH AVE RD, SUITE A, NAMPA, ID 83686-7715
(208) 468-9400
(208) 468-9447
Mailing address
1611 12TH AVE RD, SUITE A, NAMPA, ID 83686-7715
(208) 468-9400
(208) 468-9447
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-6312
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801834866
—
ID
Enumeration date
12/11/2013
Last updated
08/24/2015
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