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Individual

GREGORY A. ATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1266 SAND BEACH RD, BAD AXE, MI 48413-8817
(989) 269-7958
(989) 269-6013
Mailing address
PO BOX 249, BAD AXE, MI 48413-0249
(989) 269-5393
(989) 269-6013

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002842
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0C26507
MEDICARE SUPPLIER #
MI
05
5098386
MI
Enumeration date
03/26/2007
Last updated
01/14/2008
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