Provider Demographics
NPI:1336127463
Name:GREGORY, JOE K (DO)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:K
Last Name:GREGORY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:435 S. CRYSTAL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1506
Mailing Address - Country:US
Mailing Address - Phone:406-496-3600
Mailing Address - Fax:406-496-3653
Practice Address - Street 1:435 S. CRYSTAL
Practice Address - Street 2:SUITE 300
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1506
Practice Address - Country:US
Practice Address - Phone:406-496-3600
Practice Address - Fax:406-496-3653
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2702207R00000X
MT12797207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ111097Medicaid
AZF009971Medicare UPIN