Individual
MR. GREGORY G. SOUTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
311 COURTHOUSE RD, PRINCETON, WV 24740-2421
(304) 487-2297
(304) 487-4802
Mailing address
311 COURTHOUSE ROAD, PRINCETON, WV 24740
(304) 487-2297
(304) 487-4802
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
950
WV
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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