Provider Demographics
NPI:1780889543
Name:D GREGORY BOTT MD PC
Entity type:Organization
Organization Name:D GREGORY BOTT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:D
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:BOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-667-6116
Mailing Address - Street 1:1870 AMHERST ST
Mailing Address - Street 2:SUITE 1-B
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2873
Mailing Address - Country:US
Mailing Address - Phone:540-667-6116
Mailing Address - Fax:
Practice Address - Street 1:1870 AMHERST ST
Practice Address - Street 2:SUITE 1-B
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2873
Practice Address - Country:US
Practice Address - Phone:540-667-6116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty