Deedrick, Gregory M

Deedrick, Gregory M is an individual health care provider with primary practice located at 777 Hemlock St , Macon GA 31201-2102. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Deedrick, Gregory M can be contacted via phone (866) 507-5244.

Contact Information

Primary practice address
777 Hemlock St Macon GA 31201-2102
Phone: (866) 507-5244
Fax: (855) 851-4405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 003888 Georgia

Profile Details

NPI number 1750502662
LBN Legal business name Deedrick, Gregory M
Credentials PA-AA
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2007
Last updated Nov 21st, 2014 - about 11 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1750502662 NPPES
Georgia MEDICAID 100002399A
Georgia Other 344300
Georgia Other 97WCDNQ
Georgia Other 100002399A
Georgia Other 430079677

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