Individual
MARK E. GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 S ACADEMY RD, GUTHRIE, OK 73044-8727
(405) 282-5125
Mailing address
4401 W MEMORIAL RD, SUITE 140, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16492
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020654565002
BCBS
OK
05
—
100231340A
—
OK
Enumeration date
02/21/2006
Last updated
05/20/2014
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