Vidal, Gregory

Vidal, Gregory is an individual health care provider with primary practice located at 7945 Wolf River Blvd , Germantown TN 38138-1762. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Vidal, Gregory can be contacted via phone (901) 683-0055.

Contact Information

Primary practice address
7945 Wolf River Blvd Germantown TN 38138-1762
Phone: (901) 683-0055
Fax: (901) 685-2969
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 23969 Mississippi
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 51775 Tennessee

Profile Details

NPI number 1730403072
LBN Legal business name Vidal, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2010
Last updated Nov 8th, 2017 - about 7 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 1730403072 NPPES
Tennessee MEDICAID Q008640
Tennessee MEDICAID 00457534
Tennessee MEDICAID 209870001

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