Provider Demographics
NPI:1770345233
Name:ESSIG, GREGORY SCOTTT
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOTTT
Last Name:ESSIG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 DALTON FOX LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44618-9403
Mailing Address - Country:US
Mailing Address - Phone:330-284-3775
Mailing Address - Fax:
Practice Address - Street 1:674 DALTON FOX LAKE RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:OH
Practice Address - Zip Code:44618-9403
Practice Address - Country:US
Practice Address - Phone:330-284-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty