Gregory Alan Tetrault, M. D.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

37956 Issued in TN

Practice address

1030 Jefferson Ave
Medical Center 614/113
Memphis, TN 38104-2127

Phone

(901) 523-8990

Fax

(901) 577-7284

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366458127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 PECAN RIDGE DR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380179096",
            "telephone_number": "901-861-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "address_2": "MEDICAL CENTER 614/113",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990",
            "fax_number": "901-577-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRAULT",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "TN",
            "license": "37956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony McKelvy Terry, BS
• Simon Haileselassie Tesfau, MD
• Amanuel Tesfazion, DPH
• Meron Kedeme Teshome, M.D.
• Test Anywhere LLC
• John P Tetzeli, M.D.
• Marta Christina Tetzeli, PH.D.
• Mallory Tew, DPT
• Lisa Thabet, MSPC
• Amber Thacker, MD

• Clinical Pathology/Laboratory Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Pathology/Laboratory Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.