Healthcare Provider Details

I. General information

NPI: 1760407951
Provider Name (Legal Business Name): JOSEPH M GRAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 REDMOND RD NW
ROME GA
30165-1415
US

IV. Provider business mailing address

501 REDMOND RD NW
ROME GA
30165-1415
US

V. Phone/Fax

Practice location:
  • Phone: 850-210-4877
  • Fax:
Mailing address:
  • Phone: 850-210-4877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME94101
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME94101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: