Individual
JASON R. GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
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
Update your record
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