Individual
DR. GREGORY LEE PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O., M.P.H.
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2253
Mailing address
5282 FARMRIDGE WAY, MASON, OH 45040-3649
(513) 398-0460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34.006699
OH
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
34.006699
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611097900
DOL OWCP PROVIDER NUMBER
—
01
—
PA4229831
MEDICARE PTAN
OR
Enumeration date
06/19/2007
Last updated
01/14/2020
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