Individual
DR. KENNETH ALLEN GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1133
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09345
BCBS PROV #
NC
05
—
7909345
—
NC
01
—
P00777283
RR MCARE
NC
Enumeration date
04/11/2006
Last updated
11/20/2014
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