Basic Information
| Provider Information | |||||||||
| NPI: | 1760461735 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOBES | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 425 ESSJAY RD | ||||||||
| Address2: | STE 170 | ||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142215782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166301219 | ||||||||
| FaxNumber: | 7168171726 | ||||||||
| Practice Location | |||||||||
| Address1: | 3900 N. BUFFALO ROAD | ||||||||
| Address2: | |||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7169951021 | ||||||||
| FaxNumber: | 7162505961 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2006 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 231416-1 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02564029 | 05 | NY | MEDICAID | 161000580 | 01 | NY | UNITED HEALTHCARE | OTHER | 161000580 | 01 | NY | AETNA | OTHER | 161000580 | 01 | NY | NORTH AMERICAN PREFERRED | OTHER | 00026795601 | 01 | NY | UNIVERA | OTHER | 000527697001 | 01 | NY | HEALTH NOW | OTHER | 0412502 | 01 | NY | IHA | OTHER | 161000580 | 01 | NY | EMPIRE | OTHER | P00159069 | 01 | NY | RR MEDICARE | OTHER |