Provider Demographics
NPI:1760485890
Name:HALE, GREGORY A (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:HALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 5TH ST S
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4804
Mailing Address - Country:US
Mailing Address - Phone:727-767-4176
Mailing Address - Fax:727-767-4379
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-4176
Practice Address - Fax:727-767-4379
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1031012080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR274936Medicaid
NC7609090Medicaid
NE100249681-00Medicaid
AL009912800Medicaid
OK100033230AMedicaid
ME422400000Medicaid
FL000162400Medicaid
MS00120827Medicaid
KS200362500AMedicaid
MO205027600Medicaid
TN3897713Medicaid
SCQ31510Medicaid
IA0527655Medicaid
IN200236950AMedicaid
KY64315013Medicaid
LA1429660Medicaid
AR136990001Medicaid
AZ564238Medicaid
RIGH59805Medicaid
SCQ31510Medicaid