Provider Demographics
NPI:1194964510
Name:GREGORY W. SCHALL, DO, PLLC
Entity type:Organization
Organization Name:GREGORY W. SCHALL, DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-490-8215
Mailing Address - Street 1:312 W HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033
Mailing Address - Country:US
Mailing Address - Phone:270-692-9559
Mailing Address - Fax:270-692-9236
Practice Address - Street 1:312 W HIGH STREET
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033
Practice Address - Country:US
Practice Address - Phone:270-692-9559
Practice Address - Fax:270-692-9236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty