Provider Demographics
NPI:1538594379
Name:EMFIELD, GREGORY SCOTT (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOTT
Last Name:EMFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 N 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-3324
Mailing Address - Country:US
Mailing Address - Phone:208-234-4100
Mailing Address - Fax:
Practice Address - Street 1:246 N 18TH AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-3324
Practice Address - Country:US
Practice Address - Phone:208-234-4100
Practice Address - Fax:208-234-4192
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO-1409207W00000X
ND15906207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology