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Organization

JIMMY L. GREGORY DPM, INC

Active
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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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