# J MARK GRESHAM MD PC

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

## Provider details

- **NPI number:** 1952574550
- **Authorized official:** DR. JONES MARK GRESHAM M.D. (OWNER)
- **Authorized official phone:** (706) 437-0770

## Contact information

- **Practice address:** 301 JONES AVE, WAYNESBORO, GA 30830-1510
- **Practice address phone:** (706) 437-0770
- **Practice address fax:** (706) 437-0540
- **Mailing address:** 301 JONES AVE, P O BOX 328, WAYNESBORO, GA 30830-1510
- **Mailing address phone:** (706) 437-0770
- **Mailing address fax:** (706) 437-0540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 039358 | GA | Yes |

## Other

- **Enumeration date:** 04/04/2008
- **Last updated:** 06/06/2008