Provider Demographics
NPI:1326255126
Name:ALBERT, GREGORY W (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:W
Last Name:ALBERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 CHILDREN'S WAY
Mailing Address - Street 2:SLOT 838
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3591
Mailing Address - Country:US
Mailing Address - Phone:501-364-1448
Mailing Address - Fax:501-364-3621
Practice Address - Street 1:1 CHILDREN'S WAY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3591
Practice Address - Country:US
Practice Address - Phone:501-364-1448
Practice Address - Fax:501-364-3621
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAR-7028207T00000X
IA38401207T00000X
ARE-7062207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI0923233Medicare PIN