Basic Information
| Provider Information | |||||||||
| NPI: | 1831105972 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCANINCH | ||||||||
| FirstName: | GREGG | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2087 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897022087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758881180 | ||||||||
| FaxNumber: | 7758526902 | ||||||||
| Practice Location | |||||||||
| Address1: | 2874 N CARSON ST | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897060251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758881180 | ||||||||
| FaxNumber: | 7758526902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 09/18/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | G64756 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 7202 | NV | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | MD00024407 | WA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.