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NPI Code Detail

MEDICARE: HARRISON M GRAY M.D.

MEDICARE:   HARRISON M GRAY  M.D.
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
1207Q00000XFamily Medicine Physician63334TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700376407
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARRISON M GRAY M.D.
Provider Business Mailing Address
First Line : 5000 CROSSINGS CIR STE 103
Second Line :
City : MOUNT JULIET
State : TN
Zip : 37122-8591
Country : US
Telephone Number : 615-680-0110
Fax Number : 615-549-7044
Provider Business Practice Location Address
First Line : 2525 PERIMETER PLACE DR STE 105
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3674
Country : US
Telephone Number : 615-680-0110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2018
Last Update Date : 10/20/2023

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