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Contact Information

GREGORY D LOOSE, OD
1113 CENTRAL AVE E
WIGGINS, MS39577-9605
 Phone: 601-928-3914
 Fax: 601-928-2207
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for GREGORY D LOOSE · (Male)

NPI Number 1013096825
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 11/03/2006
Last updated 02/26/2008 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 758
  • MS Medicaid 01374059
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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