Provider Demographics
NPI:1194136556
Name:HOLTON, GREGORY ALLAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALLAN
Last Name:HOLTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:231-672-7800
Mailing Address - Fax:231-672-7801
Practice Address - Street 1:1675 LEAHY ST STE 201A
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5542
Practice Address - Country:US
Practice Address - Phone:231-672-7800
Practice Address - Fax:231-672-7801
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301116240207R00000X
TXBP10049459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine