Provider Demographics
NPI:1295748614
Name:SEPANSKI, GREGORY JOHN (MD)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:JOHN
Last Name:SEPANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:860 N DEAN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-9401
Mailing Address - Country:US
Mailing Address - Phone:334-826-8246
Mailing Address - Fax:334-826-8746
Practice Address - Street 1:860 N DEAN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-9401
Practice Address - Country:US
Practice Address - Phone:334-826-8246
Practice Address - Fax:334-826-8746
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21550207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00386215OtherMEDICARE RAILROAD
ALSE000098798Medicaid
AL051540150OtherMEDICARE
AL51540150OtherBLUE CROSS
ALSE000098797Medicaid
AL051098797OtherBLUE CROSS OF ALABAMA
AL051098798OtherBLUE CROSS OF ALABAMA
0810221OtherUNITED HEALTHCARE
AL529932350Medicaid
AL009942236Medicaid
DF6980OtherMEDICARE RAILROAD
AL208366414OtherCIGNA HEALTHCARE
ALSE000098797Medicaid
AL529932350Medicaid