Macisaac, Gregory F

Macisaac, Gregory F is an individual health care provider with primary practice located at 120 Cypress Edge Dr Suite 210, Palm Coast FL 32164-8453. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Macisaac, Gregory F can be contacted via phone (386) 445-4750.

Contact Information

Primary practice address
120 Cypress Edge Dr Suite 210 Palm Coast FL 32164-8453
Phone: (386) 445-4750
Fax: (386) 445-4751
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101057756 Virginia

Profile Details

NPI number 1104895473
LBN Legal business name Macisaac, Gregory F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Feb 12th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104895473 NPPES
Florida Other ME119474 FL MEDICAL LICENSE
Florida MEDICAID 005620589 FL MEDICAL LICENSE
Florida Other 218728 FL MEDICAL LICENSE

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