Provider Demographics
NPI:1609891035
Name:COMBS, GREGORY LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LLOYD
Last Name:COMBS
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 1:1914 WILLAMETTE FALLS DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4688
Mailing Address - Country:US
Mailing Address - Phone:503-655-9727
Mailing Address - Fax:503-655-9865
Practice Address - Street 1:1914 WILLAMETTE FALLS DR
Practice Address - Street 2:SUITE 210
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4688
Practice Address - Country:US
Practice Address - Phone:503-655-9727
Practice Address - Fax:503-655-9865
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15245208200000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR043492Medicaid
ORRBKFNCMedicare ID - Type Unspecified
ORE35447Medicare UPIN