1487637427 NPI number — DR. GREGORY SCOTT TUCKER M.D.

Table of content: MR. FRELEN HUGHES (NPI 1174331086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487637427 NPI number — DR. GREGORY SCOTT TUCKER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TUCKER
Provider First Name:
GREGORY
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487637427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2006 FRANKLIN ST SE STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35801-4537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-539-0457
Provider Business Mailing Address Fax Number:
256-539-5827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2006 FRANKLIN ST SE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35801-4551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-539-0457
Provider Business Practice Location Address Fax Number:
256-539-5827
Provider Enumeration Date:
11/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  29111 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 24561 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009910966 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009984600 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 126701 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 248063 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009942887 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 051551630 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 136996 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 234211 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 238611 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 248143 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 248933 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51067268 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51595706 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009984610 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51595705 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51595709 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 210839 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51509151 . This is a "BCBS OF AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51595707 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 249590 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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