Individual
GREGG A GOBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1693 S COLORADO ST, GREENVILLE, MS 38703-7211
(662) 332-8700
Mailing address
PO BOX 23998, JACKSON, MS 39225-3998
(662) 725-2749
(662) 725-2741
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
13979
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114112
—
MS
01
—
5J806
MEDICARE AR
AR
01
—
P00316067
RR MEDICARE
—
Enumeration date
08/12/2006
Last updated
09/26/2007
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