Provider Demographics
NPI:1629263017
Name:CHAMPNEY, GREGORY CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:CHRISTOPHER
Last Name:CHAMPNEY
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 1:154 MCAFEE BLF
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4067
Mailing Address - Country:US
Mailing Address - Phone:423-928-3861
Mailing Address - Fax:
Practice Address - Street 1:JAMES H. QUILLEN VETERAN'S AFFAIRS MEDICAL CENTER
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:MOUTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000045292208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery