# GREGORY CHIROPRACTIC CENTER

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

## Provider details

- **NPI number:** 1619298395
- **Authorized official:** DR. ROGER MILTON GREGORY III D.C. (OWNER)
- **Authorized official phone:** (601) 373-5767

## Contact information

- **Practice address:** 5604 I 55 S, BYRAM, MS 39272-9402
- **Practice address phone:** (601) 373-5767
- **Practice address fax:** (601) 372-4031
- **Mailing address:** 5604 I 55 S, BYRAM, MS 39272-9402
- **Mailing address phone:** (601) 373-5767
- **Mailing address fax:** (601) 372-4031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 589 | MS | Yes |

## Other

- **Enumeration date:** 06/17/2010
- **Last updated:** 01/22/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 08737729 | — | MS |
| 01 | — | P00035227 | RAILROAD MEDICARE | MS |