Individual
DR. JIMMY LEE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
495 WINN WAY STE 100, DECATUR, GA 30030-1709
(404) 284-7744
(404) 284-8006
Mailing address
2140 CALVERTON LANE, ATLANTA, GA 30331-1210
(404) 284-7744
(404) 284-8006
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000598
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD00598
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000430504G
PEACH STATE
GA
05
—
000430504G
—
GA
01
—
10038991
AMERIGROUP
GA
01
—
309352
WELLCARE
GA
Enumeration date
03/29/2006
Last updated
12/27/2024
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