Provider Demographics
NPI:1205825692
Name:ALES, GREGORY D (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:ALES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2312 N NEVADA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5307
Mailing Address - Country:US
Mailing Address - Phone:719-473-3272
Mailing Address - Fax:719-389-1191
Practice Address - Street 1:2312 N NEVADA AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5307
Practice Address - Country:US
Practice Address - Phone:719-473-3272
Practice Address - Fax:719-389-1191
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2015-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCDO328542084N0400X
TXM25322084N0400X
CO549092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37008366Medicaid