Individual
GREGORY ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 MEDICINE WAY RD, PERIDOT, AZ 85542-5000
(928) 475-1400
Mailing address
4756 E 10TH ST, TUCSON, AZ 85711-3006
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
58573
AZ
Other
Enumeration date
05/25/2016
Last updated
07/12/2019
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