Melancon, Gregory Nathan

Melancon, Gregory Nathan is an individual health care provider with primary practice located at 111 S Main St , Mcalester OK 74501-5303. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Melancon, Gregory Nathan can be contacted via phone (918) 423-5204.

Contact Information

Primary practice address
111 S Main St Mcalester OK 74501-5303
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1760873335
LBN Legal business name Melancon, Gregory Nathan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2015
Last updated Feb 18th, 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 1760873335 NPPES
Oklahoma MEDICAID 200305190B

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