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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