Individual
GREGORY LEE INGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 E. JEFFERSON ST., PRAIRIE CITY, IA 50228-0430
(515) 994-2617
(515) 994-2365
Mailing address
100 E. JEFFERSON STREET, PRAIRIE CITY, IA 50228-0430
(515) 994-2617
(515) 994-2365
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01695
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01695
IOWA LICENSE
IA
05
—
5151324
—
IA
01
—
560910082
MEDICARE PTAN #
IA
Enumeration date
10/05/2005
Last updated
07/21/2022
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