Provider Demographics
NPI:1366899478
Name:GREGORY, CAITLIN (OD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:SKISLAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:9709 PARKWAY E STE A&B
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-7853
Practice Address - Country:US
Practice Address - Phone:205-836-2020
Practice Address - Fax:205-836-1340
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS- D62152W00000X
ALS-D62-TA-A48152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist