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NPI Code Detail

MEDICARE: DR. DAVID J GRAY MD

MEDICARE:  DR. DAVID J GRAY  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0122XPlastic and Reconstructive Surgery Physician25672AL
22086S0122XPlastic and Reconstructive Surgery Physician282282NY
32086S0122XPlastic and Reconstructive Surgery Physician23405MS
42086S0122XPlastic and Reconstructive Surgery Physician87355GA
52086S0122XPlastic and Reconstructive Surgery Physician2017001968MO

Other Identifiers

General Provider Information

NPI Number : 1568444305
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J GRAY MD
Provider Business Mailing Address
First Line : 6491 PEACHTREE INDUSTRIAL BLVD
Second Line :
City : ATLANTA
State : GA
Zip : 30360-2100
Country : US
Telephone Number : 770-689-1858
Fax Number :
Provider Business Practice Location Address
First Line : 6491 PEACHTREE INDUSTRIAL BLVD
Second Line :
City : ATLANTA
State : GA
Zip : 30360-2100
Country : US
Telephone Number : 770-689-1858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 06/12/2023

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