Timberlake, Gregory

Timberlake, Gregory is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Timberlake, Gregory can be contacted via phone (601) 984-1000.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-1000
Fax: (601) 815-4570
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 17108 Mississippi
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 17108 Mississippi

Profile Details

NPI number 1730260613
LBN Legal business name Timberlake, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Dec 16th, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1730260613 NPPES
Mississippi MEDICAID 00123637
Mississippi Other P01233200

Popular Providers