Provider Demographics
NPI:1225113194
Name:PING, GREGORY H (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:H
Last Name:PING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5366 N 200 E
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-9625
Mailing Address - Country:US
Mailing Address - Phone:260-672-8608
Mailing Address - Fax:
Practice Address - Street 1:5366 N 200 E
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-9625
Practice Address - Country:US
Practice Address - Phone:260-672-8608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000984A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350023853OtherRAILROAD MEDICARE
IN100138180AMedicaid
IN000000079565OtherBLUE CROSS
IN100138180AMedicaid
IN371270Medicare ID - Type Unspecified