Ivins, Gregory Keith
Ivins, Gregory Keith is an sole proprietor health care provider with primary practice located at 26 S Hospital Dr , Fulton MO 65251-2510. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Ivins, Gregory Keith can be contacted via phone (573) 642-0115.Contact Information
Primary practice address
26 S Hospital Dr
Fulton MO 65251-2510
Phone: (573) 642-0115
Fax: (573) 642-4684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | R9723 | Missouri |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | R9723 | Missouri |
Profile Details
| NPI number | 1942211842 |
|---|---|
| LBN Legal business name | Ivins, Gregory Keith |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Jan 23rd, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942211842 | NPPES |
| Missouri | Other | 11090 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 431339000652510 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 224840 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 431339000 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | A11946 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 020004558 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 33711 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 11090 | BLUE CROSS/BLUE SHIELD |
| Missouri | Other | 1704001 | BLUE CROSS/BLUE SHIELD |
| Missouri | MEDICAID | 201226313 | BLUE CROSS/BLUE SHIELD |
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