Individual
DR. LAWRENCE J GREGG
Active
Individual
DR. LAWRENCE J GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
9455
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070004141
RAILROAD MEDICARE
—
05
—
100116590A
—
OK
01
—
4053536
AETNA PPO
—
01
—
730776171002
BLUE CROSS BLUE SHIELD
—
01
—
876735
AETNA HMO
—
01
—
9455
MEDICAL LICENSE NUMBER
OK
Enumeration date
09/26/2005
Last updated
05/16/2008
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