Individual
JASON R. GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3000 ST. MATTHEWS RD, ORANGEBURG, SC 29118
(803) 454-2613
(803) 765-1732
Mailing address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 682-0344
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
901
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
901
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009010
—
SC
01
—
576008010002
TRICARE
SC
01
—
576008010007
BLUE CHOICE
SC
01
—
576008010010
BCBS
SC
01
—
6958751
CIGNA
SC
01
—
7535722
AETNA
SC
Enumeration date
02/08/2006
Last updated
10/22/2021
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