Provider Demographics
NPI:1417710914
Name:GREGORY, JAMES ROBERT (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:GREGORY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4605
Mailing Address - Country:US
Mailing Address - Phone:985-872-1133
Mailing Address - Fax:
Practice Address - Street 1:501 BARROW ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4605
Practice Address - Country:US
Practice Address - Phone:985-872-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15921111N00000X
LA2029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor