DR. GREGG SYDOW (NPI# 1619157609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619157609 |
| Entity Type | Individual |
| Full Name | DR. GREGG SYDOW |
| Credential | M.D. |
| Practice Address |
4062 S Holland Rd Flagstaff AZ 86005-8967 |
| Mailing Address |
11995 Singletree Ln Ste 500 Eden Prairie MN 55344-5349 |
| Practice Telephone | 9525951100 |
| Practice Fax Number | 6122944903 |
| Mailing Telephone | 9525951301 |
| Mailing Fax Number | 6122944903 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2016-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
47172 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
4062 S HOLLAND RD |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86005-8967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851776785 | Libby Smith | Counselor | 3240 S. Trotter Lane, Flagstaff, AZ 86005 | 2015-07-21 |
| 1255484580 | Melanie Glass Watters | Physical Therapist | 2342 Mongwa Ovi, Flagstaff, AZ 86005-3531 | 2007-01-19 |
| 1609488444 | Camille Elizabeth Harding | Student in an Organized Health Care Education/Training Program | 2707 Moenkopi Trl, Flagstaff, AZ 86005-3659 | 2020-08-22 |
| 1568871366 | J Wynne Geikenjoyner | Physical Therapist | 4247 Canyon Loop, Flagstaff, AZ 86005-3726 | 2014-08-05 |
| 1174592380 | Carol L. O'saben | Psychologist | 4289 Canyon Loop, Flagstaff, AZ 86005-3726 | 2006-03-17 |
| 1275005068 | Jennifer Leigh Cody | Respite Care | 2583 Chof Trl, Flagstaff, AZ 86005-3737 | 2018-12-18 |
| 1528260155 | Laura Ann Kinghan | Occupational Therapist | 3623 Kachina Trail, #8, Flagstaff, AZ 86005-3786 | 2007-06-05 |
| 1114386570 | Laurenlee Rae | Occupational Therapist | 2580 Nakai Trl, Flagstaff, AZ 86005-3796 | 2016-02-15 |
| 1881212439 | Diana Campos | Specialist/Technologist | 3558 Huron, Flagstaff, AZ 86005-4056 | 2020-07-10 |
| 1093218877 | Vanessa Margaret Scheu | Nurse Practitioner | 3861 Jemez, Flagstaff, AZ 86005-4061 | 2018-03-17 |
| Find all providers in zip 86005 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669794053 | Ian Leroy Musil | Radiology | 77 W Forest Ave Ste 101, Flagstaff, AZ 86001-1482 | 2010-02-25 |
| 1477508935 | Jennifer J. Kottra | Radiology | 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-23 |
| 1831148147 | James T. Friedland | Radiology | 7600 Pine Canyon Dr, Flagstaff, AZ 86004-1266 | 2006-05-06 |
| 1831168426 | Steven B Jones | Radiology | 1153 N Waterside Dr, Flagstaff, AZ 86004-7964 | 2006-03-16 |
| 1366767352 | James Christen Larsen IIi | Radiology | 77 W Forest Ave Ste 101, Flagstaff, AZ 86001-1482 | 2010-04-01 |
| 1386699643 | Michael J. Labenz | Radiology | 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-24 |
| 1497700579 | Stephen V. Ward | Radiology | 77 W Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-24 |
| 1134174618 | Paul Hiette | Radiology | 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-23 |
| 1114972593 | Paul E Sangster | Radiology | 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-23 |
| 1578518957 | Edward P. Herman | Radiology | 77 W Forest Ave, Suite 101, Flagstaff, AZ 86001-1482 | 2006-05-23 |
| Find all providers in FLAGSTAFF | ||||
Please comment or provide details below to improve the information on DR. GREGG SYDOW.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.