Individual
JERRY ANTHONY GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
421 MAIN STREET, COLUMBIA, LA 71418
(318) 649-6111
(318) 649-5094
Mailing address
375 SEGUINE AVE, STATEN ISLAND, NY 10309-3932
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
014368
NY
Other
Enumeration date
08/29/2006
Last updated
09/21/2018
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