Organization
JAY GREGORY, M.D., INC. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY ALLEN GREGORY M.D. (PRESIDENT)
(918) 687-5304
Entity
Organization
Contact information
Practice address
333 S 38TH ST, SUITE D, MUSKOGEE, OK 74401-4937
(918) 687-5304
(918) 687-0178
Mailing address
333 S 38TH ST, SUITE D, MUSKOGEE, OK 74401-4937
(918) 687-5304
(918) 687-0178
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100105610A
—
OK
01
—
443481212001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
11/11/2009
Last updated
11/11/2009
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