DR. DARRYL DODD GREGERSON DC NPI 1669587077

NPI Information

NPI: 1669587077
Provider Name: DR. DARRYL DODD GREGERSON, DC
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
2518 E KENOSHA ST
BROKEN ARROW, OK
ZIP 74014
Phone: (918) 286-2729
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DR. Darryl Dodd Gregerson, DC is a chiropractor in Broken Arrow, OK. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Darryl Dodd Gregerson, DC NPI is 1669587077. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2518 E KENOSHA ST
BROKEN ARROW, OK
ZIP 74014-712
Phone: (918) 286-2729
Fax: (918) 286-0651

The enumeration date for this NPI number is 8/19/2006 and was last updated on 7/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		3878	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U53570	MEDICARE UPIN
2	I14836	MEDICARE ID-TYPE UNSPECIFIED	IOWA
3	46813	OTHER	IOWA	BLUE CROSS/BLUE SHIELD
4	2118786	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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