Provider Demographics
NPI:1073595351
Name:BECHILL, GREGORY BRIAN (DO)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:BRIAN
Last Name:BECHILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:BECHILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-463-3101
Mailing Address - Fax:
Practice Address - Street 1:1910 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1298
Practice Address - Country:US
Practice Address - Phone:989-463-3101
Practice Address - Fax:989-463-2824
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4278207Q00000X
MI5101015442207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ952376Medicaid
AZ952376Medicaid
AZ952376Medicaid