Provider Demographics
NPI:1487637427
Name:TUCKER, GREGORY SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:TUCKER
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 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN291112085R0202X
AL245612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009910966Medicaid
AL009984600Medicaid
AL126701Medicaid
AL248063Medicaid
AL009942887Medicaid
AL051551630Medicaid
AL136996Medicaid
AL234211Medicaid
AL238611Medicaid
AL248143Medicaid
AL248933Medicaid
AL51067268OtherBCBS
AL51595706OtherBCBS
AL009984610Medicaid
AL51595705OtherBCBS
AL51595709OtherBCBS
AL210839Medicaid
AL51509151OtherBCBS OF AL
AL51595707OtherBCBS
AL249590Medicaid
AL51595708OtherBCBS
AL009984800Medicaid
AL248094Medicaid
AL51595710OtherBCBS