Healthcare Provider Details
I. General information
NPI: 1629869326
Provider Name (Legal Business Name): HUNTER MICHAEL GRAY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1323 W 6TH AVE
STILLWATER OK
74074-4306
US
IV. Provider business mailing address
2313 W 40TH ST
STILLWATER OK
74074-2487
US
V. Phone/Fax
- Phone: 405-784-5842
- Fax:
- Phone: 512-662-6501
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: