Provider Demographics
NPI:1598767378
Name:BLAND, GREGORY FRANKLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:FRANKLIN
Last Name:BLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 N UNION BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4900
Mailing Address - Country:US
Mailing Address - Phone:719-634-0107
Mailing Address - Fax:719-634-5832
Practice Address - Street 1:3920 N UNION BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4900
Practice Address - Country:US
Practice Address - Phone:719-634-0107
Practice Address - Fax:719-634-5832
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33406208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF79082Medicare UPIN