Individual
GREGORY D DABOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7545 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5806
(901) 759-3100
(901) 759-3196
Mailing address
1400 S GERMANTOWN RD, GERMANTOWN, TN 38138-2205
(901) 759-3100
(901) 759-3916
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
15741
MS
207X00000X
Orthopaedic Surgery Physician
34061
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122613
—
MS
05
—
140940001
—
AR
05
—
3851421
—
TN
Enumeration date
09/27/2005
Last updated
05/01/2018
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