Provider Demographics
NPI:1699733113
Name:GASS, GREGORY L (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:L
Last Name:GASS
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 1:234 MORRELL RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5876
Mailing Address - Country:US
Mailing Address - Phone:865-766-0092
Mailing Address - Fax:865-766-0182
Practice Address - Street 1:234 MORRELL RD
Practice Address - Street 2:SUITE 3O3
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5876
Practice Address - Country:US
Practice Address - Phone:865-766-0092
Practice Address - Fax:865-766-0182
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD165382084P0800X, 207LP3000X
NY2514542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3895808Medicaid
TN3895808Medicare ID - Type Unspecified
TN3895808Medicaid