Male or Other

Gregory S. Borucki D.O.

Emergency Medicine Physician in Madison, AL(View on Map)

Full Name

Gregory S Borucki D.O.

NPI Number

1013995554

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/05/2006

Specialties

(Taxonomies)

Code

207P00000X
207R00000X

Primary Taxonomy

Yes
No

Licenses

State

Alabama

License Number

DO-719

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 6568
124 BLUFF SPRING DR

City

Huntsville
Madison

State

AL
AL

Postal Code

35824-0568
35758-7386

Country

US
US

Telephone Number

(256) 325-4075
(256) 325-4075

Identifiers

Identifier

A-1381-06
CS00211972
DO-719

Identifier State

NM
NM
AL

Identifier Issuer

LICENSE
CONTROLLED SUBSTANCE
LICENSE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/07/2023

Provider Address

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