Provider Demographics
NPI:1831197672
Name:MCGEE, GREGORY SULLIVAN (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:SULLIVAN
Last Name:MCGEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-5340
Mailing Address - Country:US
Mailing Address - Phone:228-497-7576
Mailing Address - Fax:228-497-8869
Practice Address - Street 1:4300 HOSPITAL ST STE 106
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5306
Practice Address - Country:US
Practice Address - Phone:228-809-5380
Practice Address - Fax:228-809-5386
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000156772086S0129X
MS242922086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00118976Medicaid
AL510-29922OtherBLUE CROSS BLUE SHIELD
E76622Medicare UPIN
AL000029922Medicaid