Individual
DR. GREGORY WAYNE BETTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(321) 480-5017
Mailing address
PO BOX 278, COCOA, FL 32923-0278
(321) 480-5017
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME80681
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259398000
—
FL
01
—
35744
BLUCROSS BLUESHIELD
FL
Enumeration date
05/23/2005
Last updated
05/07/2008
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