Organization
DONALD KEVIN GREGORY MD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA GAIL GREGORY (OFFICE MANAGER)
(270) 274-4771
Entity
Organization
Contact information
Practice address
1213 N MAIN ST., BEAVER DAM, KY 42320-0308
(270) 274-4771
(270) 274-4884
Mailing address
1213 NORTH MAIN ST., BEAVER DAM, KY 42320-0308
(270) 274-4771
(270) 274-4884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
298623
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000528018
ANTHEM
—
01
—
11750443
CAQH
—
01
—
298623
LICENSE
KY
05
—
64298623
—
KY
Enumeration date
10/31/2007
Last updated
10/31/2007
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