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NPI Code Detail

MEDICARE: HEATHER M GRAY DPM

MEDICARE: HEATHER M GRAY DPM
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
1213ES0103XFoot & Ankle Surgery Podiatrist36.003578OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1480031634OTHEROHRAILROAD MEDICARE
2CB6624OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619103314
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER M GRAY DPM
Provider Business Mailing Address
First Line : 1138 W HIGH ST
Second Line :
City : LIMA
State : OH
Zip : 45805-2725
Country : US
Telephone Number : 419-225-2726
Fax Number : 419-228-9909
Provider Business Practice Location Address
First Line : 1138 W HIGH ST
Second Line :
City : LIMA
State : OH
Zip : 45805-2725
Country : US
Telephone Number : 419-225-2726
Fax Number : 419-228-9909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2009
Last Update Date : 03/03/2021

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Practice Location Address:
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1114923398 — SHAWN C WARD DPM
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1114100831 — WEST CENTRAL OHIO PODIATRY INC.
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1568606093 — ALISON RENEE NIEMEYER DPM
Practice Location Address:
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1538850888 — VICTORIA ALANE WISE CNP
Practice Location Address:
1138 W HIGH ST
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Directions to “ HEATHER M GRAY DPM” Practice Location

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