Provider Demographics
NPI:1295232635
Name:DRG23
Entity Type:Organization
Organization Name:DRG23
Other - Org Name:DAVID GREELEY, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:GREELEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-220-9608
Mailing Address - Street 1:26 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1309
Mailing Address - Country:US
Mailing Address - Phone:509-747-5615
Mailing Address - Fax:
Practice Address - Street 1:26 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1309
Practice Address - Country:US
Practice Address - Phone:509-747-5615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty