Provider Demographics
NPI:1013189885
Name:GREGORY, PAUL ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ROBERT
Last Name:GREGORY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32271 K22
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51108-8644
Mailing Address - Country:US
Mailing Address - Phone:712-239-4849
Mailing Address - Fax:
Practice Address - Street 1:32271 K22
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51108-8644
Practice Address - Country:US
Practice Address - Phone:712-239-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19544207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology