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Individual

JOSEPH E GREGORY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
5405 INDIAN HILL BLVD, DIAMONDHEAD, MS 39525-3324
(228) 255-8585
(228) 875-2092
Mailing address
1410 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-2916
(228) 875-2088
(228) 875-2092

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
574
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880009
MS
01
1902060643
NPI
MS
01
1962658203
NPI
MS
01
410027652
RAILROAD MEDICARE PTAN
MS
Enumeration date
09/27/2006
Last updated
02/09/2009
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