Healthcare Provider Details

I. General information

NPI: 1275799371
Provider Name (Legal Business Name): PAULETTE LUCILLE GREY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 SAINT CHARLES AVE
NEW ORLEANS LA
70130-4445
US

IV. Provider business mailing address

1523 SAINT CHARLES AVE
NEW ORLEANS LA
70130-4445
US

V. Phone/Fax

Practice location:
  • Phone: 504-374-1000
  • Fax: 504-374-1350
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number322792
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: