Provider Demographics
NPI:1558997486
Name:BACKES, GREGORY LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LOUIS
Last Name:BACKES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-713-0947
Mailing Address - Fax:
Practice Address - Street 1:791 JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1252
Practice Address - Country:US
Practice Address - Phone:336-716-4551
Practice Address - Fax:336-716-4962
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA3232812084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry