Provider Demographics
NPI:1538373980
Name:DOSS, GREGORY K (OMD CA LIC AC)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:K
Last Name:DOSS
Suffix:
Gender:M
Credentials:OMD CA LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:910 NE D STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2325
Mailing Address - Country:US
Mailing Address - Phone:541-476-4611
Mailing Address - Fax:541-476-1592
Practice Address - Street 1:910 NE D STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2325
Practice Address - Country:US
Practice Address - Phone:541-476-4611
Practice Address - Fax:541-476-1592
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORAC00085171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist