Micklow, Gregory

Micklow, Gregory is an individual health care provider with primary practice located at 100 Northcrest Dr , Springfield TN 37172-3927. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Micklow, Gregory can be contacted via phone (931) 647-5034.

Contact Information

Primary practice address
100 Northcrest Dr Springfield TN 37172-3927
Phone: (931) 647-5034
Fax: (931) 552-6663
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 81596 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 45339 Tennessee

Profile Details

NPI number 1154365518
LBN Legal business name Micklow, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Apr 17th, 2014 - about 10 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 1154365518 NPPES
Florida Other 196453355 CHAMPUS
Florida Other 06040 CHAMPUS
Florida MEDICAID 264082100 CHAMPUS

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