Provider Demographics
NPI:1568572543
Name:GREGG, DON W (RPH)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:W
Last Name:GREGG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WEXTON CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-7011
Mailing Address - Country:US
Mailing Address - Phone:706-563-7475
Mailing Address - Fax:
Practice Address - Street 1:1627 S LUMPKIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-2719
Practice Address - Country:US
Practice Address - Phone:706-687-6869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist