Organization
JIMMY L. GREGORY DPM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA LOVE (OFFICE MANAGER)
(404) 284-7744
Entity
Organization
Contact information
Practice address
3546 COVINGTON HWY, SUITE C, DECATUR, GA 30032-1823
(404) 284-7744
(404) 284-8006
Mailing address
2140 CALVERTON LANE, ATLANTA, GA 30331-2235
(404) 202-8916
(404) 284-8006
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
000598
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC7572
MEDICARE RAILROAD
GA
01
—
GRP6110
MEDICARE PART B
GA
Enumeration date
05/23/2007
Last updated
09/22/2009
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