Provider Demographics
NPI:1821221136
Name:GREAVES, JOHN PITCHFORD JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PITCHFORD
Last Name:GREAVES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15742 MIDDLETOWN PARK DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-9753
Mailing Address - Country:US
Mailing Address - Phone:530-244-1299
Mailing Address - Fax:530-246-9501
Practice Address - Street 1:15742 MIDDLETOWN PARK DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-9753
Practice Address - Country:US
Practice Address - Phone:530-244-1299
Practice Address - Fax:530-246-9501
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC37307207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology