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Individual

JOHN B GREGORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
127 MASCOMA ST, LEBANON, NH 03766-2661
(603) 443-9572
(603) 443-9521
Mailing address
10 ALICE PECK DAY DR, LEBANON, NH 03766-2900
(603) 443-9572
(603) 443-9521

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0305
NH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0305
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00068170
BLUE CROSS BLUE SHIELD
VT
01
03Y007385NH02
ANTHEM BCBS
NH
05
1011596
VT
05
30363594
NH
01
U71898
HARVARD PILGRIM
Enumeration date
08/11/2006
Last updated
04/14/2017
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