Provider Demographics
NPI:1679545438
Name:LEUNG, GARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:F
Last Name:LEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2055 NORMANDIE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2732
Mailing Address - Country:US
Mailing Address - Phone:334-269-6337
Mailing Address - Fax:334-834-0657
Practice Address - Street 1:2055 NORMANDIE DR
Practice Address - Street 2:108
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2732
Practice Address - Country:US
Practice Address - Phone:334-288-4624
Practice Address - Fax:334-280-3628
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL000208082085R0202X
FLME918392085R0202X
TXJ97402085R0202X
AL208082085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000058866OtherIDTF
AL106717Medicaid
AL108260Medicaid
AL009973305Medicaid
AL000032539Medicaid
AL000058867OtherIDTF
AL009951045Medicaid
AL108177Medicaid
AL000044695Medicaid
AL000044694Medicaid
AL000044697Medicaid
AL009973315Medicaid
AL009973345Medicaid
AL000032533Medicaid
AL051504364OtherIDTF
AL106716Medicaid
AL108260Medicaid
AL051504364OtherIDTF
AL009973305Medicaid
AL106716Medicaid