Provider Demographics
NPI:1407994619
Name:GREGORY A. MOWERY, MD PLLC
Entity Type:Organization
Organization Name:GREGORY A. MOWERY, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-778-9440
Mailing Address - Street 1:2001 MALLORY LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8233
Mailing Address - Country:US
Mailing Address - Phone:615-778-9440
Mailing Address - Fax:
Practice Address - Street 1:2001 MALLORY LN
Practice Address - Street 2:SUITE 105
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8233
Practice Address - Country:US
Practice Address - Phone:615-778-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD024439207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF70146Medicare UPIN
TN3723201Medicare ID - Type Unspecified