Provider Demographics
NPI:1598340044
Name:BILLINGS, GREGORY ROBERT (MPAS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ROBERT
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N STAPLEY DR STE B
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-8057
Mailing Address - Country:US
Mailing Address - Phone:807-181-2904
Mailing Address - Fax:480-718-1301
Practice Address - Street 1:220 N STAPLEY DR STE B
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-8057
Practice Address - Country:US
Practice Address - Phone:480-718-1290
Practice Address - Fax:480-718-1301
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8207363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical