Provider Demographics
NPI:1275503104
Name:HALE, GREGORY J (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1306 BELK BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5302
Mailing Address - Country:US
Mailing Address - Phone:662-236-6636
Mailing Address - Fax:662-236-6602
Practice Address - Street 1:1306 BELK BLVD STE A
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5302
Practice Address - Country:US
Practice Address - Phone:662-236-6636
Practice Address - Fax:662-236-6602
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS12842207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology