Provider Demographics
NPI:1326242991
Name:GREGONIS, ERICA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:LOUISE
Last Name:GREGONIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-7676
Mailing Address - Country:US
Mailing Address - Phone:859-737-6499
Mailing Address - Fax:859-737-6651
Practice Address - Street 1:793 EASTERN BYP STE 216
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2443
Practice Address - Country:US
Practice Address - Phone:859-624-6540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8688207R00000X
KY45164207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2775947229OtherMYUTMB 2775947229-COMMERCIAL NUMBER
2775947229OtherMYUTMB 2775947229-COMMERCIAL NUMBER