Healthcare Provider Details

I. General information

NPI: 1528565025
Provider Name (Legal Business Name): DORIAN PAUL GRAY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 E MARKET ST
AKRON OH
44305-2421
US

IV. Provider business mailing address

725 E MARKET ST
AKRON OH
44305-2421
US

V. Phone/Fax

Practice location:
  • Phone: 330-434-4141
  • Fax:
Mailing address:
  • Phone: 330-434-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number34.014481
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number34.014481
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34.014481
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: