Aycock, Gregory Jackson

Aycock, Gregory Jackson is an individual health care provider with primary practice located at 615 S New Ballas Rd Dept Of , Saint Louis MO 63141-8221. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, Pharmacy Service Providers / Pharmacist. Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant is his primary health care specialty. Aycock, Gregory Jackson can be contacted via phone (636) 386-9224.

Contact Information

Primary practice address
615 S New Ballas Rd Dept Of Saint Louis MO 63141-8221
Phone: (636) 386-9224
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 75000176A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X PENDING Missouri
Pharmacy Service Providers / Pharmacist 183500000X PS40328 Florida
Pharmacy Service Providers / Pharmacist 183500000X 17641 North Carolina

Profile Details

NPI number 1215924527
LBN Legal business name Aycock, Gregory Jackson
Credentials CAA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated May 10th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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