Organization
GARY GREGERSON, M.D., P.A.
Active
Other names
Advanced Specialty Care For Women
Organization subpart
No
Provider details
NPI number
Authorized official
GARY NED GREGERSON (PRESIDENT)
(208) 468-9400
Entity
Organization
Contact information
Practice address
1611 12TH AVE RD, SUITE A, NAMPA, ID 83686-7715
(208) 468-9400
(208) 468-9447
Mailing address
1611 12TH AVE RD, SUITE A, NAMPA, ID 83686-7715
(208) 468-9400
(208) 468-9447
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-6312
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801834866
—
ID
Enumeration date
12/11/2013
Last updated
08/24/2015
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