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Organization

MICHAEL J. GREGSON, M.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL J. GREGSON M.D., P.A. (PHYSICIAN, OWNER)
(208) 232-8300
Entity
Organization

Contact information

Practice address
1950 E CLARK ST, SUITE C, POCATELLO, ID 83201-3314
(208) 232-8300
(208) 232-8303
Mailing address
PO BOX 4907, POCATELLO, ID 83205-4907
(208) 232-8300
(208) 232-8303

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M3289
ID

Other

Enumeration date
12/27/2011
Last updated
12/27/2011
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