Provider Demographics
NPI:1568696243
Name:FERENZ, GREGORY J (DO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:FERENZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 NE SAVANNAH DR STE 2
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4866
Mailing Address - Country:US
Mailing Address - Phone:541-508-0393
Mailing Address - Fax:800-853-1280
Practice Address - Street 1:568 NE SAVANNAH DR STE 2
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4866
Practice Address - Country:US
Practice Address - Phone:541-508-0393
Practice Address - Fax:800-853-1280
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT0123882084N0400X
CODR.00569572084N0600X
ORDO1623672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP01255924OtherMEDICARE RAILROAD
OR500659636Medicaid
ORP01255924OtherMEDICARE RAILROAD