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Organization
FAMILY MED LLC
Active
Organization
FAMILY MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY L GREGSTON MD (PHYSICIAN)
(580) 252-0500
Entity
Organization
Contact information
Practice address
2004 N HIGHWAY 81, DUNCAN, OK 73533-1460
(580) 252-0500
(580) 252-1020
Mailing address
2004 N HIGHWAY 81, DUNCAN, OK 73533-1460
(580) 252-0500
(580) 252-1020
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100118660F
—
OK
05
—
100254370B
—
OK
05
—
200116880B
—
OK
05
—
20116880A
—
OK
01
—
586187246001
BCBS PIN
OK
Enumeration date
05/09/2007
Last updated
01/17/2024
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