Provider Demographics
NPI:1588634083
Name:GURCZAK, PATRICIA BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:BARBARA
Last Name:GURCZAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:1041 BALCH RD
Practice Address - Street 2:SUITE 350
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8343
Practice Address - Country:US
Practice Address - Phone:256-265-5955
Practice Address - Fax:256-265-5956
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21478207RC0000X
NMMD2006-0439207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM77200373Medicaid
NMP00372295OtherRAILROAD MEDICARE
NM00NM001N01OtherBCBS
NM00NM001N01OtherBCBS
NM77200373Medicaid