Provider Demographics
NPI:1952523607
Name:GREGG, FREDERICK O'NEAL (DO)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:O'NEAL
Last Name:GREGG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3688 VETERANS MEMORIAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401
Mailing Address - Country:US
Mailing Address - Phone:601-554-7400
Mailing Address - Fax:601-554-7488
Practice Address - Street 1:3688 VETERANS MEMORIAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401
Practice Address - Country:US
Practice Address - Phone:601-554-7400
Practice Address - Fax:601-554-7488
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001226207X00000X
MS20954207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery