Provider Demographics
NPI:1710948948
Name:GRECO, JOHN J (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:GRECO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-539-2728
Mailing Address - Fax:256-428-3423
Practice Address - Street 1:927 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-539-2728
Practice Address - Fax:256-428-3423
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15847207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0910080OtherUNITED HEALTHCARE
AL000078783Medicaid
AL51078783OtherBCBS
AL5708109OtherAETNA
AL200042032OtherRAILROAD MEDICARE
AL0910080OtherUNITED HEALTHCARE
AL000078783Medicaid