Gregg P Standage MD

NPI #1235416918 in Prescott, Arizona

Provider Information

NPI Number: 1235416918
Entity Type: Organization
Organization Name: Gregg P Standage MD
Primary Specialty: Specialist
Enumeration Date: Nov 9, 2011
Last Updated: Dec 27, 2011

Practice Location

Address: 705 W HILLSIDE AVE
City: Prescott
State: Arizona
ZIP Code: 86301-1938
Phone: (928) 348-1374

Authorized Official

Name: DR. GREGG P STANDAGE, MD
Title: MD
Phone: (928) 348-1374

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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