Provider Demographics
NPI:1144209578
Name:GREGORY, JOSEPH GRANVILLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GRANVILLE
Last Name:GREGORY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 660816
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35266-0816
Mailing Address - Country:US
Mailing Address - Phone:205-913-6611
Mailing Address - Fax:205-623-5551
Practice Address - Street 1:1736 OXMOOR RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4058
Practice Address - Country:US
Practice Address - Phone:205-913-6611
Practice Address - Fax:205-623-5551
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000240002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51119463OtherBCBS OF ALABAMA