Provider Demographics
NPI:1023101938
Name:SWEAT, GREGORY T (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:T
Last Name:SWEAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 E FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1632
Mailing Address - Country:US
Mailing Address - Phone:913-789-1940
Mailing Address - Fax:
Practice Address - Street 1:7301 E FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-1632
Practice Address - Country:US
Practice Address - Phone:913-789-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04-30307207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17282051OtherBLUE CROSS
KSK21C557Medicare ID - Type Unspecified
KS17282051OtherBLUE CROSS
KSS142447Medicare ID - Type Unspecified