Provider Demographics
NPI:1063452720
Name:CARSON, GREGORY BECKWITH (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:BECKWITH
Last Name:CARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:79 SAILFISH DR
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1312
Mailing Address - Country:US
Mailing Address - Phone:609-264-1588
Mailing Address - Fax:609-264-0755
Practice Address - Street 1:2605 SHORE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2136
Practice Address - Country:US
Practice Address - Phone:609-365-5333
Practice Address - Fax:609-365-5306
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04942000207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine