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Individual

DR. DANE GREGORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
320 DOUBLE TREE DR SE, CALHOUN, GA 30701-4665
(706) 602-9771
Mailing address
320 DOUBLE TREE DR SE, CALHOUN, GA 30701-4665
(706) 602-9771

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
050884
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000941366L
GA
05
121044531A
GA
01
417905286
TRICARE
GA
Enumeration date
05/04/2006
Last updated
03/04/2010
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